Department of Surgery, Chonnam National University Medical School, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jellanam-do, 519-809, Korea.
Surg Today. 2012 Apr;42(4):386-90. doi: 10.1007/s00595-011-0080-x. Epub 2012 Jan 19.
Primary extragastrointestinal stromal tumors (EGISTs) arising in the pancreas are extremely rare, with only ten cases documented to our knowledge. We report a further case of EGIST of the pancreas. The patient was a 55-year-old man who presented with postprandial abdominal discomfort. Abdominal computed tomography and magnetic resonance imaging showed a lobulated heterogenous enhancing mass, 11 cm in diameter, in the abdominal cavity. No regional lymphadenopathy, ascites, or metastasis was seen radiologically. There was no obvious lesion in the stomach or small intestine. The initial diagnosis was a solid pseudopapillary tumor or serous cystic neoplasm. The patient underwent distal pancreatectomy with splenectomy. Microscopically, the tumor consisted of spindle cells arranged in short fascicles. Mitotic figures were seen in 7/50 high-power fields. Immunohistochemical examination revealed strongly positive staining for CD117. Based on these findings, the final pathologic diagnosis was a primary EGIST of the pancreas. This case consolidates the possibility that this rare tumor can involve the pancreas as a primary site and should be included in the differential diagnosis of cystic lesions in this site.
原发于胰腺的胃肠道外间质瘤(EGIST)极为罕见,据我们所知,仅有 10 例文献报道。我们报告了胰腺 EGIST 的进一步病例。患者为 55 岁男性,表现为餐后腹部不适。腹部 CT 和磁共振成像显示腹腔内直径 11cm 的分叶状混杂强化肿块。影像学未见区域性淋巴结病、腹水或转移。胃或小肠无明显病变。最初的诊断是实性假乳头状瘤或浆液性囊腺瘤。患者接受了胰体尾切除术加脾切除术。镜下,肿瘤由排列成短束的梭形细胞组成。高倍镜下可见 7/50 有丝分裂象。免疫组化检查显示 CD117 强阳性染色。根据这些发现,最终的病理诊断为胰腺原发性 EGIST。该病例证实了这种罕见肿瘤可作为原发部位累及胰腺的可能性,并且应纳入该部位囊性病变的鉴别诊断。