Hirano Satoshi, Kondo Satoshi, Ambo Yoshiyasu, Tanaka Eiichi, Morikawa Toshiaki, Okushiba Shunichi, Katoh Hiroyuki
Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-Ku, Sapporo 060-8638, Japan.
World J Surg. 2005 Feb;29(2):208-11. doi: 10.1007/s00268-004-7006-3.
Almost all reported cases of intraductal papillary-mucinous tumors of the pancreas (IPMTs) originate from Wirsung's duct (WD), the main pancreatic duct, or their branches. IPMTs arising from Santorini's duct (SD) and its branches have rarely been reported. This article presents the clinicopathologic features of IPMTs originating in SD and its branches. Of 36 IPMTs resected in our institution, 5 originated in the region of SD: 3 in SD and 2 from its branches. Both SD and WD were dilated in all cases on radiographic and ultrasonographic studies. The maximum diameter of SD, determined by computed tomography or ultrasonography, was larger than that of WD in all cases. Seven reports of IPMT arising from SD have been published. Four lesions originated from SD and the others from its branches. Overall, 9 of 12 lesions (75%) were considered malignant. In conclusion, the coexistence of an IPMT and a dilated SD suggests an origin in the SD. These tumors have a high malignant potential and should be excised.
几乎所有报道的胰腺导管内乳头状黏液性肿瘤（IPMTs）均起源于主胰管即Wirsung管（WD）或其分支。起源于Santorini管（SD）及其分支的IPMTs鲜有报道。本文介绍了起源于SD及其分支的IPMTs的临床病理特征。在我们机构切除的36例IPMTs中，5例起源于SD区域：3例起源于SD，2例起源于其分支。影像学和超声检查显示，所有病例中SD和WD均有扩张。通过计算机断层扫描或超声检查确定的SD最大直径在所有病例中均大于WD。已发表7例起源于SD的IPMT报道。4个病变起源于SD，其他起源于其分支。总体而言，12个病变中有9个（75%）被认为是恶性的。总之，IPMT与扩张的SD并存提示起源于SD。这些肿瘤具有较高的恶性潜能，应行切除。
