Kobayashi Tsutomu, Shimura Tatsuo, Araki Ken-ichiro, Mochida Yasushi, Suzuki Hideki, Suehiro Taketoshi, Kuwano Hiroyuki
Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
Int Surg. 2009 Apr-Jun;94(2):176-81.
A 29-year-old woman was referred to our hospital with a pancreatic cystic tumor diagnosed by computed tomography and magnetic resonance imaging. Endoscopic retrograde cholangiopancreatography was performed, wherein macrocystic serous cystadenoma of the pancreas was diagnosed. It was decided to observe the progress of the disease. The tumor diameter increased over 18 months to > 50 mm. Its growth rate was slower than the average rate of serous cystadenoma described in previous reports, but its form become warped and shaped like bunches of grapes. A branch duct variant of intraductal papillary mucinous neoplasm could not be excluded. Laparoscope-assisted distal pancreatectomy was performed, and the pathological diagnosis was macrocystic serous cystadenoma. Some macrocystic serous cystadenomas are like an intraductal papillary mucinous neoplasm, and differential diagnosis is very difficult. The macrocystic serous cystadenoma is a rare lesion, but it should be considered when diagnosing cystic tumors of the pancreas.
一名29岁女性因计算机断层扫描和磁共振成像诊断为胰腺囊性肿瘤而转诊至我院。进行了内镜逆行胰胆管造影，诊断为胰腺大囊型浆液性囊腺瘤。决定观察病情进展。肿瘤直径在18个月内增大至>50 mm。其生长速度比既往报道的浆液性囊腺瘤平均生长速度慢，但其形态变得扭曲，呈葡萄串状。不能排除导管内乳头状黏液性肿瘤的分支导管型。实施了腹腔镜辅助远端胰腺切除术，病理诊断为大囊型浆液性囊腺瘤。一些大囊型浆液性囊腺瘤类似导管内乳头状黏液性肿瘤，鉴别诊断非常困难。大囊型浆液性囊腺瘤是一种罕见病变，但在诊断胰腺囊性肿瘤时应予以考虑。
