Choi Sung Hoon, Hwang Ho Kyoung, Kang Chang Moo, Lee Woo Jung
Division of Biliopancreas, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
JOP. 2010 Nov 9;11(6):638-41.
Mucinous cystic tumors occur almost exclusively in middle-aged women and in the body or tail of the pancreas. Mucinous cystadenocarcinoma, a malignant sub-type of mucinous cystic tumors, in the head of the pancreas and in a middle-aged man is extraordinary, and the prognosis and proper management of mucinous cystadenocarcinoma has not been well documented.
A 52-year-old male patient with a mucinous cystadenocarcinoma approximately 5.5 cm in size in the head of the pancreas underwent a total pancreaticoduodenectomy and segmental resection of the superior mesenteric vein-portal vein confluence with an autologous splenic vein graft due to tumor invasion. His postoperative course was uneventful and he received adjuvant chemotherapy. He has been followed-up periodically for more than 30 months after surgery without evidence of recurrence.
Mucinous cystadenocarcinoma in the head of the pancreas in a middle-aged man is an extremely rare case. Because mucinous cystadenocarcinomas have a relatively good prognosis, an aggressive approach with major vascular resection is warranted in well-selected patients. Splenic vein interposition grafting could be used in cases which undergo total pancreaticoduodenectomy with segmental resection of the superior mesenteric vein-portal vein confluence if the splenic vein is healthy.
黏液性囊性肿瘤几乎仅发生于中年女性以及胰腺体部或尾部。胰腺头部的黏液性囊腺癌是黏液性囊性肿瘤的一种恶性亚型，发生于中年男性则极为罕见，且黏液性囊腺癌的预后及恰当治疗方法尚无充分记录。
一名52岁男性患者，胰腺头部有一个大小约5.5厘米的黏液性囊腺癌，因肿瘤侵犯接受了全胰十二指肠切除术及肠系膜上静脉-门静脉汇合处的节段性切除，并进行了自体脾静脉移植。他术后恢复顺利，接受了辅助化疗。术后已定期随访30多个月，无复发迹象。
中年男性胰腺头部的黏液性囊腺癌是极为罕见的病例。由于黏液性囊腺癌预后相对较好，对于精心挑选的患者，采用积极的主要血管切除方法是必要的。如果脾静脉健康，在进行全胰十二指肠切除术及肠系膜上静脉-门静脉汇合处节段性切除的病例中可使用脾静脉间置移植术。
