Zhang Q-Y, Shen Q-Y, Yan S, Zheng S-S
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Int Med Res. 2011;39(4):1555-62. doi: 10.1177/147323001103900447.
Primary pancreatic leiomyosarcoma is a rare mesenchymal tumour that is believed to arise from the walls of the pancreatic blood vessels or the pancreatic duct. A 56-year-old female was referred with epigastric pain and abdominal mass. Preoperative computed tomography showed a large soft tissue mass in the pancreatic body and tail. Fine needle aspiration biopsy indicated a spindle cell type tumour. The patient received distal pancreatectomy with no adjuvant treatment. Histology revealed a pleomorphic spindle cell neoplasm with an immunoprofile suggestive of smooth muscle origin. The absence of other lesions in the body was consistent with the diagnosis of primary pleomorphic leiomyosarcoma. The patient was well and tumour-free 14 months after surgery. Detailed immunohistochemical analyses are necessary in the diagnosis of this highly malignant tumour. Radical resection offers the only chance of long-term survival.
原发性胰腺平滑肌肉瘤是一种罕见的间叶性肿瘤，据信起源于胰腺血管壁或胰管。一名56岁女性因上腹部疼痛和腹部肿块前来就诊。术前计算机断层扫描显示胰体和胰尾有一个大的软组织肿块。细针穿刺活检显示为梭形细胞型肿瘤。患者接受了胰体尾切除术，未进行辅助治疗。组织学检查显示为多形性梭形细胞瘤，免疫表型提示起源于平滑肌。体内无其他病变与原发性多形性平滑肌肉瘤的诊断相符。患者术后14个月情况良好，无肿瘤复发。对于这种高度恶性肿瘤的诊断，详细的免疫组化分析是必要的。根治性切除是长期生存的唯一机会。
