胰腺导管内乳头状黏液性肿瘤术后复发并伴有胃瘘
Postoperative recurrence of an IPMN of the pancreas with a fistula to the stomach.
作者信息
Uesato Masaya, Nabeya Yoshihiro, Miyazaki Shinichi, Aoki Taito, Akai Takashi, Shuto Kiyohiko, Tanizawa Tohru, Miyazaki Masaru, Matsubara Hisahiro
机构信息
Masaya Uesato, Yoshihiro Nabeya, Takashi Akai, Kiyohiko Shuto, Hisahiro Matsubara, Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan.
出版信息
World J Gastrointest Endosc. 2010 Oct 16;2(10):349-51. doi: 10.4253/wjge.v2.i10.349.
We report on a case of a 74 year old man who was diagnosed with a recurrence of non-invasive carcinoma of intraductal papillary mucinous neoplasm (non-invasive IPMN) by postoperative gastroscopy (GS). A pylorus preserving pancreatico duodenectomy for IPMN in the pancreatic head was performed. A histopathological study revealed non-invasive adenocarcinoma. At first, the local recurrence of the tumor around the superior mesenteric artery circumference was diagnosed and disappeared with gemcitabine. Later, the GS showed the elevated lesion with mucin hypersecretion in the remnant stomach. The lesion had a central dip and a fistula common to the pancreas was confirmed on fisterography. We diagnosed a recurrence of IPMN and administered chemotherapy again. However, he died of his original illness. There are no reports of postoperative recurrence of IPMN checked by GS. It should be remembered that the elevated lesion of the remnant stomach is considered as one of the recurrent patterns of IPMN.
我们报告了一例74岁男性患者，其通过术后胃镜检查（GS）被诊断为导管内乳头状黏液性肿瘤非侵袭性癌（非侵袭性IPMN）复发。对胰头部的IPMN进行了保留幽门的胰十二指肠切除术。组织病理学研究显示为非侵袭性腺癌。起初，诊断为肠系膜上动脉周围肿瘤局部复发，吉西他滨治疗后复发灶消失。后来，GS显示残胃内病变隆起且黏液分泌过多。病变中央有凹陷，瘘管造影证实存在与胰腺相通的瘘管。我们诊断为IPMN复发并再次给予化疗。然而，他最终死于原发病。目前尚无通过GS检查IPMN术后复发的相关报道。应记住，残胃内病变隆起被视为IPMN复发模式之一。
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