Garg Mrinal S, Schuerle Theresa, Liu Yulin, Thakkar Shyam J
Division of Gastroenterology, Allegheny Health Network, Allegheny General Hospital. Pittsburgh, PA, USA.
JOP. 2015 Jan 31;16(1):63-5. doi: 10.6092/1590-8577/2899.
Cystic neoplasms, which are less common forms of exocrine pancreatic neoplasms, consist of mainly intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms. Mucinous cystic neoplasms, unlike IPMN, are not associated with ductal growth, are usually multilocular in nature, and have ovarian type stroma. Mucinous cystadenocarcinoma is a type of mucinous cystic neoplasm more commonly found in women. Intraductal oncocytic papillary neoplasms of the pancreas are the least common variant of IPMN. Despite this classification, intraductal oncocytic papillary neoplasms have been compared to mucinous cystic neoplasms in previous studies and the classification is still questioned.
We report a rare case of an intraductal oncocytic papillary neoplasm of the pancreas occurring in a 52-year-old male with a prior history of surgically excised mucinous cystadenocarcinoma. This is the first known case of an intraductal oncocytic papillary neoplasm occurring after a prior pancreatic neoplasm.
As the diagnosis of intraductal oncocytic papillary neoplasms are rare, having only a few case reports and small series on which to understand its disease process, it is imperative to discuss each case and detail possible correlations with other pancreatic cystic neoplasms as well as distinctions from its current association within IPMN.
胰腺囊性肿瘤是胰腺外分泌肿瘤中较罕见的类型，主要包括导管内乳头状黏液性肿瘤（IPMN）和黏液性囊性肿瘤。与IPMN不同，黏液性囊性肿瘤与导管生长无关，通常为多房性，并有卵巢型间质。黏液性囊腺癌是黏液性囊性肿瘤的一种类型，多见于女性。胰腺导管内嗜酸性乳头状肿瘤是IPMN中最罕见的变异型。尽管有此分类，但在以往研究中，胰腺导管内嗜酸性乳头状肿瘤已与黏液性囊性肿瘤进行了比较，其分类仍受到质疑。
我们报告了一例罕见的胰腺导管内嗜酸性乳头状肿瘤，发生在一名52岁男性身上，该男性既往有黏液性囊腺癌手术切除史。这是已知的首例胰腺导管内嗜酸性乳头状肿瘤发生于既往胰腺肿瘤之后的病例。
由于胰腺导管内嗜酸性乳头状肿瘤的诊断罕见，仅有少数病例报告和小系列研究可用于了解其疾病过程，因此有必要讨论每一例病例，并详细阐述其与其他胰腺囊性肿瘤可能的相关性以及与目前在IPMN中的关联的区别。
