Department of Surgery, University of Texas Medical Branch, 301 University Boulevard, JSA 6.312, Galveston, TX 77555-0542, USA.
J Gastrointest Surg. 2012 May;16(5):1064-71. doi: 10.1007/s11605-011-1797-y. Epub 2011 Dec 9.
Neoplasms of the pancreas during pregnancy are rare, with less than 25 cases of benign and malignant tumors reported in the literature.
We present three unique cases of pancreatic tumors occurring during pregnancy--one mucinous cystic neoplasm and two adenocarcinomas. We review the literature regarding pancreatic neoplasms during pregnancy and discuss the diagnosis, complications, and management of these tumors.
Magnetic resonance imaging and ultrasound are the imaging modalities of choice in pregnancy. In patients with benign or premalignant tumors, surgical resection may be postponed until the second trimester. In symptomatic patients, or if there is a concern for intrauterine growth restriction, urgent surgical intervention should be performed. With malignant tumors, the benefit of delaying surgery must be balanced with the risk of maternal disease progression. Termination of the pregnancy should be discussed when a malignant tumor is diagnosed during the first trimester. Pancreatic tumors diagnosed during the third trimester may be resected after delivery. If malignant, early delivery of the fetus and subsequent maternal operation can be considered at appropriate fetal maturity.
When these tumors occur during pregnancy, they present a diagnostic and treatment dilemma, with variation in treatment based on gestational age and patient preference.
妊娠期胰腺肿瘤罕见，文献报道良性和恶性肿瘤病例不足 25 例。
我们报告了妊娠期间发生的 3 例胰腺肿瘤的独特病例，其中包括 1 例黏液性囊腺瘤和 2 例腺癌。我们回顾了妊娠期胰腺肿瘤的文献，并讨论了这些肿瘤的诊断、并发症和处理方法。
磁共振成像和超声是妊娠期间的首选影像学检查方法。对于良性或癌前病变患者，手术切除可推迟至孕中期。对于有症状的患者，或如果担心胎儿宫内生长受限，应紧急进行手术干预。对于恶性肿瘤，必须权衡延迟手术的益处与母亲疾病进展的风险。在孕早期诊断出恶性肿瘤时应考虑终止妊娠。在妊娠晚期诊断出的胰腺肿瘤可在分娩后进行切除。如果为恶性肿瘤，可以考虑在适当的胎儿成熟度时尽早分娩胎儿并随后对母亲进行手术。
当这些肿瘤在妊娠期间发生时，会出现诊断和治疗上的困境，治疗方法因孕龄和患者意愿而异。
