Goh Brian K P, Chung Yaw-Fui Alexander, Ng David C E, Selvarajan Sathiyamoorthy, Soo Khee-Chee
Departments of Surgery, Nuclear Medicine, and Pathology, Singapore General Hospital. Singapore, Singapore.
JOP. 2007 May 9;8(3):350-4.
A 79-year-old Indian male was admitted with upper abdominal discomfort of 1-year duration which was associated with loss of weight and appetite. Serum tumor markers, including carcinoembryonic antigen and carbohydrate antigen 19-9, were within normal limits. A computed tomographic scan demonstrated a cystically dilated and tortuous pancreatic duct measuring 1.9 cm, suggestive of an intraductal papillary mucinous neoplasm. Fusion positron emission tomography/computed tomography with 2-deoxy-2-[18F] fluoro-D-glucose positron emission tomography (FDG-PET/CT) which was subsequently performed confirmed a metabolically active focus within the pancreatic head mass with a standard uptake value (SUVmax) of 3.5 compatible with carcinoma. A total pancreatectomy was performed and the final histology demonstrated a main-duct type intraductal papillary mucinous neoplasm with a focus of high-grade dysplasia compatible with carcinoma-in-situ. These images illustrate the emerging utility of FDG-PET/CT in the preoperative detection of malignancy in intraductal papillary mucinous neoplasm.
一名79岁的印度男性因持续1年的上腹部不适入院，该症状伴有体重减轻和食欲减退。包括癌胚抗原和糖类抗原19-9在内的血清肿瘤标志物均在正常范围内。计算机断层扫描显示胰管呈囊性扩张且迂曲，直径为1.9厘米，提示导管内乳头状黏液性肿瘤。随后进行的2-脱氧-2-[18F]氟-D-葡萄糖正电子发射断层扫描融合正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）证实胰头肿块内有一个代谢活跃灶，标准摄取值（SUVmax）为3.5，符合癌的表现。实施了全胰切除术，最终组织学检查显示为导管内乳头状黏液性肿瘤主胰管型，伴有一处高级别发育异常灶，符合原位癌。这些图像说明了FDG-PET/CT在导管内乳头状黏液性肿瘤术前恶性病变检测中的新兴应用价值。
