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孕期大型胰腺实性假乳头状肿瘤的手术治疗

Surgical therapy of a large pancreatic solid-pseudopapillary neoplasm during pregnancy.

作者信息

MacDonald Frank, Keough Valerie, Huang Weei-Yuan, Molinari Michele

机构信息

Department of Surgery, Dalhousie University, Halifax, Canada.

出版信息

BMJ Case Rep. 2014 Jan 20;2014:bcr2013202259. doi: 10.1136/bcr-2013-202259.

Abstract

Solid-pseudopapillary neoplasms (SPNs) of the exocrine pancreas are rare, accounting for only 2% of pancreatic tumours. These tumours predominantly affect women during the second and third decades of life. They frequently present with vague symptoms and can pose a diagnostic challenge. Surgical resection remains the treatment of choice that can cure up to 95% of patients when negative resection margins are obtained. SPNs diagnosed during pregnancy are exceptional and with profound implications on the mother and fetus. The authors present a case of an asymptomatic SPN in a 24-year-old woman diagnosed at 14 weeks of gestation on a routine prenatal ultrasound. Distal pancreatectomy, splenectomy and cholecystectomy were successfully performed at 18 weeks of gestation. A healthy full-term male child was born 5 months following surgery without complications.

摘要

胰腺外分泌部的实性假乳头状肿瘤(SPN)较为罕见,仅占胰腺肿瘤的2%。这些肿瘤主要影响二三十岁的女性。它们常常表现出模糊的症状,可能带来诊断挑战。手术切除仍是首选治疗方法,若切缘阴性,高达95%的患者可被治愈。孕期诊断出的SPN非常罕见,对母亲和胎儿都有深远影响。作者报告了一例24岁女性的无症状SPN病例,该病例在妊娠14周时通过常规产前超声检查被诊断出来。在妊娠18周时成功进行了远端胰腺切除术、脾切除术和胆囊切除术。术后5个月,一名健康的足月男婴顺利出生,无并发症。

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本文引用的文献

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Solid-pseudopapillary neoplasm: a pancreatic enigma.实性假乳头状肿瘤:胰腺之谜。
Arch Pathol Lab Med. 2009 Dec;133(12):1989-93. doi: 10.5858/133.12.1989.
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Papillary-cystic neoplasm of the pancreas. A sex-steroid dependent tumor.
Int J Pancreatol. 1998 Dec;24(3):219-25. doi: 10.1007/BF02788425.

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