Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Korean J Intern Med. 2011 Sep;26(3):348-51. doi: 10.3904/kjim.2011.26.3.348. Epub 2011 Sep 13.
The most common pancreatic cancer is adenocarcinoma. Primary adenosquamous cell carcinoma of the pancreas is very rare and aggressive. A 46-year-old man presented with a 3-month history of dyspepsia and a 7-kg weight loss. The physical examination showed tenderness of the right upper quadrant of the abdomen. There was no jaundice. Amylase and lipase were elevated. CA 19-9 was elevated to 566.7 U/mL. Gastroduodenoscopy showed a hard ulceroinfiltrative mass with a yellowish exudate that bled readily on touch in the second portion of the duodenum. Abdominal computed tomography showed a 7.1 × 6.3-cm heterogeneously enhancing mass in the pancreatic head. The pancreatic mass had invaded the duodenum wall, gastric antrum, and gastroduodenal artery sheath. Fine-needle aspiration biopsy of the pancreatic mass revealed adenosquamous cell carcinoma, anaplastic type. We concluded that an adenosquamous cell carcinoma of pancreas had invaded the duodenal mucosa causing ulceration.
最常见的胰腺癌是腺癌。胰腺的原发性腺鳞癌非常罕见且具有侵袭性。一位 46 岁男性因消化不良病史 3 个月和体重减轻 7kg 就诊。体格检查显示右上腹压痛。无黄疸。淀粉酶和脂肪酶升高。CA 19-9 升高至 566.7 U/mL。胃镜检查显示十二指肠第二段有一个坚硬的溃疡浸润性肿块，表面有黄色渗出物，触之易出血。腹部计算机断层扫描显示胰头部有一个 7.1×6.3cm 的不均匀增强肿块。胰头肿块已侵犯十二指肠壁、胃窦和胃十二指肠动脉鞘。胰腺肿块的细针穿刺活检显示为腺鳞癌，间变型。我们诊断为胰腺腺鳞癌侵犯十二指肠黏膜导致溃疡。
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