Yu Ri-Sheng, Chen Ying, Wang Liu-Hong, Xu Xiu-Fang, Jiang Ding-Yao
Department of Radiology, Hangzhou, The Second Affiliated Hospital, Zhejiang University, School of Medicine, China.
Turk J Gastroenterol. 2009 Dec;20(4):291-4. doi: 10.4318/tjg.2009.0030.
Somatostatinomas are extremely rare endocrine tumors, and those with diameters above 2 cm are reported to increase the risk of metastasis significantly. We report a case of a large functional somatostatinoma in the pancreatic tail without metastases. A 46-year-old woman with a history of recurrent mild upper abdominal pain and diarrhea for 10 months was admitted to our hospital. Multiple-phase spiral computed tomography revealed a 10 cm x 8 cm, ill-defined, elliptic mass in the body and tail of the pancreas. There was a slightly heterogeneous enhancement on hepatic arterial phase and isodensity to the pancreatic parenchyma with small dotted necrosis within the middle region of the mass on hepatic portal venous and parenchymal phase, with patent splenic vein, dilated collaterals at the splenic hilum and no dilated pancreatic duct, resembling a diffuse infiltration tumor. To the best of our knowledge, this is the first description of multiple-phase spiral computed tomography findings of a functional somatostatinoma in the pancreatic tail and the largest thus far on reported computed tomography, with some differences compared with the previous reports.
生长抑素瘤是极其罕见的内分泌肿瘤，据报道直径大于2cm的肿瘤发生转移的风险显著增加。我们报告一例位于胰尾的无转移的大型功能性生长抑素瘤病例。一名46岁女性，有反复轻度上腹痛和腹泻10个月的病史，入住我院。多期螺旋计算机断层扫描显示胰腺体尾部有一个10cm×8cm、边界不清的椭圆形肿块。肝动脉期有轻度不均匀强化，在肝门静脉期和实质期与胰腺实质呈等密度，肿块中部有小片状坏死，脾静脉通畅，脾门处有扩张的侧支血管，胰管未扩张，类似弥漫浸润性肿瘤。据我们所知，这是首次对胰尾功能性生长抑素瘤的多期螺旋计算机断层扫描表现进行描述，也是迄今为止报道的计算机断层扫描中最大的病例，与之前的报道有一些差异。
