十二指肠节细胞性副神经节瘤导致急性胰腺炎反复发作：一例报告
Recurrent episodes of acute pancreatitis due to duodenal gangliocytic paraganglioma: report of a case.
作者信息
Asimakopoulou Natalia I, Papakonstantinou Panteleimon E, Lasithiotakis Konstantinos G, Mouzas Ioannis A, Daskalogiannaki Maria E, Tzardi Maria N, Chalkiadakis George E
机构信息
Department of General Surgery, University Hospital of Heraklion, Medical School, University of Crete. Heraklion, Crete, Greece.
出版信息
JOP. 2014 Mar 10;15(2):201-5. doi: 10.6092/1590-8577/1615.
CONTEXT
Gangliocytic paraganglioma is a rare tumor, almost always located in the second portion of the duodenum, and manifested with upper gastrointestinal bleeding and abdominal pain. To date, only one case of duodenal gangliocytic paraganglioma presented with recurrent acute pancreatitis has been reported in the literature.
CASE REPORT
We present a 72-year-old woman admitted to the hospital due to recurrent episodes of acute pancreatitis. Paraclinical examinations showed a polypoid mass in the second portion of duodenum which was removed surgically by local excision. The preoperative differential diagnosis was suggestive with gastrointestinal stromal tumor or adenoma. The histopathology examination revealed a duodenal gangliocytic paraganglioma. After a follow up period of seventeen months the patient remained without clinical evidence of tumor recurrence.
CONCLUSION
Our case report draws attention to the need for including in our differential diagnosis of recurrent acute pancreatitis the mechanical obstruction of the pancreatic duct due to this tumor.
背景
神经节细胞性副神经节瘤是一种罕见肿瘤，几乎总是位于十二指肠第二部，表现为上消化道出血和腹痛。迄今为止，文献中仅报道过1例十二指肠神经节细胞性副神经节瘤表现为复发性急性胰腺炎。
病例报告
我们报告1例72岁女性患者，因复发性急性胰腺炎入院。辅助检查显示十二指肠第二部有一个息肉样肿物，通过局部切除手术将其切除。术前鉴别诊断提示为胃肠道间质瘤或腺瘤。组织病理学检查显示为十二指肠神经节细胞性副神经节瘤。经过17个月的随访，患者无肿瘤复发的临床证据。
结论
我们的病例报告提醒注意，在复发性急性胰腺炎的鉴别诊断中需要考虑到该肿瘤导致的胰管机械性梗阻。
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