Department of Gastroenterological Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
Surg Today. 2011 Nov;41(11):1556-61. doi: 10.1007/s00595-010-4536-1. Epub 2011 Oct 4.
Leiomyosarcoma of the pancreas is a rare neoplasm, with only 34 reported cases in the literature. We encountered a rare case of leiomyosarcoma of the pancreas, treated successfully by surgery. A 41-year-old woman was referred to our hospital for further examinations of a pancreatic tumor. Imaging studies demonstrated a solid and lobular mass, about 4 cm in diameter, in the body of pancreas. This mass had a nonuniform content and was encapsulated. We performed distal pancreatectomy and splenectomy for an assumed diagnosis of invasive ductal carcinoma. Macroscopically, a sagittal section of the operative specimen showed a well-circumscribed yellowish-white mass without any cystic changes. Immunohistological examination revealed that α-smooth muscle actin, desmin, and vimentin were positive, and the labeling index of MIB-1 was 50% or more. Based on these findings, we confirmed a diagnosis of leiomyosarcoma originating from the pancreas. During 14 months of follow-up to date, there has not been any evidence of local recurrence or distant metastasis.
胰腺平滑肌肉瘤是一种罕见的肿瘤，文献中仅有 34 例报道。我们遇到了一例胰腺平滑肌肉瘤的罕见病例，经手术成功治疗。一位 41 岁女性因胰腺肿瘤到我院进一步检查。影像学研究显示，胰腺体部有一个直径约 4 厘米的实性分叶状肿块。该肿块内容物不均匀，有包膜。我们行胰体尾切除术加脾切除术，术前诊断为浸润性导管癌。大体标本矢状切面显示，一个边界清楚的黄白色肿块，无任何囊性改变。免疫组织化学检查显示，α-平滑肌肌动蛋白、结蛋白和波形蛋白阳性，MIB-1 的标记指数为 50%或以上。根据这些发现，我们确诊为来源于胰腺的平滑肌肉瘤。随访至今 14 个月，未见局部复发或远处转移的证据。
