Division of Tumor Pathology, Department of Pathological Sciences, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Pathol Int. 2011 Jan;61(1):28-33. doi: 10.1111/j.1440-1827.2010.02609.x. Epub 2010 Nov 3.
Mucinous cystic neoplasm (MCN) of the pancreas is characterized by mucin-producing columnar epithelium and an ovarian-type stroma. It occurs almost exclusively in women and is almost always located in the pancreatic body or tail. Here, we report a case of large MCN located in the pancreatic head but not in the body nor tail in a 32-year-old pregnant woman, which was thought to have grown rapidly during pregnancy. It was ruptured at 34 weeks of gestation and the patient was admitted to the emergency department of the University of Fukui Hospital with an acute abdomen. Emergency cesarean section followed by pancreaticoduodenectomy was performed. The tumor consisted of many small cysts lined by a single-layer of mucinous epithelium with papillary growth and partial solid parts showing invasive growth and sarcomatoid changes, indicating mucinous cystic neoplasm with an associated invasive carcinoma (previously referred as mucinous cystadenocarcinoma). Thickened septa revealed ovarian-type stroma strongly positive for α-inhibin and partly positive for progesterone receptor immunohistochemically. We also review and discuss previous reports of MCNs including those with an associated invasive carcinoma in pregnant patients.
胰腺黏液性囊性肿瘤（MCN）的特征是产生黏蛋白的柱状上皮和卵巢样基质。它几乎仅发生于女性，几乎总是位于胰体或胰尾。在此，我们报告一例位于胰头部的大型 MCN，但不在胰体或胰尾，发生于一名 32 岁的孕妇，考虑在妊娠期间快速生长。患者于妊娠 34 周时破裂，因急腹症入住福井大学医院的急诊部。随后进行了紧急剖宫产术和胰十二指肠切除术。肿瘤由许多内衬单层黏液上皮的小囊肿组成，呈乳头状生长，部分实性部分呈浸润性生长和肉瘤样改变，提示伴有浸润性癌的黏液性囊性肿瘤（以前称为黏液性囊腺癌）。增厚的隔膜在卵巢样基质中强烈表达α-抑制素，部分孕激素受体免疫组化阳性。我们还回顾和讨论了之前报道的 MCN 病例，包括合并有浸润性癌的孕妇病例。
