Department of Surgical Oncology and Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University School of Medical and Dental Science, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Surg Today. 2010 Jun;40(6):569-73. doi: 10.1007/s00595-008-4089-8. Epub 2010 May 23.
A 44-year-old man was attending routine follow-up 5 years after colon cancer resection, when ultrasonography detected a pancreatic tumor with a low echoic area. He had no symptoms. Computed tomography (CT) showed a protruding-type tumor, 4 cm in diameter, in the pancreatic head with central necrosis. Angiography revealed that the tumor was hypervascular. The serum somatostatin level was elevated, at 27 pg/ml (normal range, 1.0-12 pg/ml). As somatostatinoma of the pancreas was suspected, we performed pylorus-preserving pancreaticoduodenectomy. Histological and immunohistochemical staining confirmed somatostatinoma of the pancreas without nodal metastasis. Thus, if an endocrine tumor of the pancreas is suspected in a patient with a hypervascular tumor, the possibility of somatostatinoma should be included in the differential diagnosis.
一位 44 岁男性因结肠癌切除术后 5 年常规随访就诊,超声检查发现胰腺有一个低回声区域的肿瘤。他没有任何症状。计算机断层扫描(CT)显示胰头部有一个直径 4 厘米的外生性肿瘤,伴有中央坏死。血管造影显示肿瘤为富血管性。血清生长抑素水平升高,为 27 pg/ml(正常值为 1.0-12 pg/ml)。由于怀疑为胰腺生长抑素瘤,我们进行了保留幽门的胰十二指肠切除术。组织学和免疫组织化学染色证实为胰腺生长抑素瘤,无淋巴结转移。因此,如果怀疑患者的富血管性肿瘤为胰腺内分泌肿瘤,则应将生长抑素瘤纳入鉴别诊断。