Ogura Takeshi, Masuda Daisuke, Kurisu Yoshitaka, Miyamoto Yoshiharu, Hayashi Michihiro, Imoto Akira, Takii Michiaki, Takeuchi Toshihisa, Inoue Takuya, Tokioka Satoshi, Uchiyama Kazuhisa, Umegaki Eiji, Higuchi Kazuhide
The 2nd Department of Internal Medicine, Osaka Medical College, Japan.
Intern Med. 2013;52(5):561-6. doi: 10.2169/internalmedicine.52.8594. Epub 2013 Mar 1.
A 60-year-old woman was referred to our hospital with swelling of the right leg. After surgery, leiomyosarcoma of the right leg was diagnosed. Computed tomography showed two hypovascular masses in the pancreatic body and tail that were heterogeneously enhanced compared with the pancreatic parenchyma. On endoscopic ultrasonography, the tumors in the pancreatic body and tail both exhibited regular margins and were visualized as well-circumscribed masses with uneven interiors. Distal pancreatectomy was performed under a presumptive diagnosis of metastatic pancreatic leiomyosarcoma diagnosed based on the findings of EUS-FNA. On laparotomy, peritoneal washing cytology yielded negative results, and no dissemination was observed. Ultimately, metastatic pancreatic leiomyosarcoma was histologically diagnosed.
一名60岁女性因右腿肿胀被转诊至我院。手术后，诊断为右腿平滑肌肉瘤。计算机断层扫描显示胰体和胰尾有两个低血运肿块，与胰腺实质相比强化不均匀。在内镜超声检查中，胰体和胰尾的肿瘤边缘均规则，表现为边界清晰、内部不均匀的肿块。根据超声内镜引导下细针穿刺活检（EUS-FNA）结果，在疑似转移性胰腺平滑肌肉瘤的诊断下进行了胰体尾切除术。剖腹手术时，腹腔冲洗细胞学检查结果为阴性，未观察到播散。最终，经组织学诊断为转移性胰腺平滑肌肉瘤。
