Fahimi Hossein, Faridi Maziar, Gholamin Sharareh, Molanaee Simin, Khorsandi Maziar
Department of Surgery, Iran Mehr Hospital, Tehran, Iran.
JOP. 2010 Nov 9;11(6):617-9.
Cystic lymphangiomas originate as benign masses which occur mostly in children especially in the head and neck region and/or the groin. Although abdominal lymphangiomas are rare, they are most commonly reported in adults. In addition, pancreatic involvement is rare. Lymphatic malformation with blockage of the lymphatic flow is the most common etiology leading to the formation of lymphangiomas. Cystic lymphangiomas should always be included in the differential diagnosis of abdominal masses which present with mass effect signs and symptoms. Due to its rarity, it forms a diagnostic and therapeutic challenge for the clinician.
We herein report the case of a 43-year-old man with a cystic lymphangioma detected in the head of the pancreas and describe the surgical procedure utilized as the therapeutic medium.
To remove this mass, we utilized a modified approach to a classic pancreaticoduodenectomy. This technique involved resection of the head of the pancreas while preserving the upper 2nd portion of the duodenum and the ampulla of Vater. The result of our 30-month follow-up of this patient has been very satisfactory with no complications.
囊性淋巴管瘤起源于良性肿块,多见于儿童,尤其是头颈部和/或腹股沟区。虽然腹部淋巴管瘤罕见,但最常见于成人。此外,胰腺受累罕见。淋巴管阻塞导致的淋巴管畸形是导致淋巴管瘤形成的最常见病因。囊性淋巴管瘤应始终纳入具有占位效应体征和症状的腹部肿块的鉴别诊断。由于其罕见性,它对临床医生构成了诊断和治疗挑战。
我们在此报告一例43岁男性患者,在胰头发现囊性淋巴管瘤,并描述了作为治疗手段所采用的手术方法。
为切除该肿块,我们采用了改良的经典胰十二指肠切除术方法。该技术包括切除胰头,同时保留十二指肠第二部上段和 Vater 壶腹。对该患者进行30个月的随访结果非常满意,无并发症发生。