Schlitter A M, Konukiewitz B, Kleeff J, Klöppel G, Esposito I
Institut für Allgemeine Pathologie und Pathologische Anatomie, Technische Universität München.
Dtsch Med Wochenschr. 2013 May;138(20):1050-3. doi: 10.1055/s-0032-1333038. Epub 2013 May 13.
In a 17-year-old girl recurrent duodenal ulcer bleeding had led to severe anemia.
Sonography and computed tomography revealed a partially cystic tumour of the pancreatic head and suspicious hepatic lesions. TREATMENT AND PATHOLOGICAL DIAGNOSIS: A partial duodenopancreatectomy was performed and two liver metastases were resected. Histological examination of the resected pancreatic specimen revealed a solid pseudopapillary neoplasm of the pancreas (SPN) with hepatic metastases. CLINICAL COURSE AND PROGNOSIS: The seven remaining liver metastases were removed in a second procedure (right hepatectomy). One year later two new liver metastases were treated by radiofrequency ablation. Two years after the initial operation, the patient is well and tumor-free.
SPN is a rare cystic tumor that is mainly found in young women. Direct tumor infiltration of stomach or duodenum can cause gastrointestinal bleedings in rare cases. Resection of the primary tumor and surgical or interventional removal of metastases are the treatment of choice.
一名17岁女孩反复出现十二指肠溃疡出血，导致严重贫血。
超声检查和计算机断层扫描显示胰头有部分囊性肿瘤以及可疑的肝脏病变。
实施了十二指肠胰腺部分切除术，并切除了两处肝转移灶。对切除的胰腺标本进行组织学检查，结果显示为胰腺实性假乳头状瘤（SPN）伴肝转移。
在第二次手术（右半肝切除术）中切除了其余7处肝转移灶。一年后，通过射频消融术治疗了两处新出现的肝转移灶。初次手术后两年，患者情况良好，未发现肿瘤。
SPN是一种罕见的囊性肿瘤，主要见于年轻女性。在罕见情况下，肿瘤直接浸润胃或十二指肠可导致胃肠道出血。切除原发肿瘤以及手术或介入清除转移灶是首选的治疗方法。
