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成人胰腺母细胞瘤的临床病理回顾

Clinicopathological review of pancreatoblastoma in adults.

作者信息

Omiyale Ayodeji Oluwarotimi

机构信息

Department of Surgery, Heart of England NHS Trust, Birmingham, UK.

出版信息

Gland Surg. 2015 Aug;4(4):322-8. doi: 10.3978/j.issn.2227-684X.2015.04.05.

Abstract

Pancreatoblastoma (PB) is a rare malignant neoplasm of the pancreas with unknown etiology. It occurs mostly in the pediatric population with very rare documented cases in adults. This is a review of the case reports of the adult pancreatoblastoma in the literature. A total of 35 cases were identified and reviewed with the mean age of 41 years (range, 18-78 years) and the male sex accounted for 51.4% of the cases. Adult Pancreatoblastoma seem to have a predilection for the head of the pancreas which accounted for approximately 49% of the cases reviewed with an average size of 8 cm (range, 1.8-20 cm). The median follow up for patients was 15 months (range, 1-108 months) Metastatic disease and local infiltration of surrounding tissues is common with poor prognosis in adult patients. Preoperative diagnosis is difficult because of the unhelpful tumor markers in adults and the cellular heterogeneity of the tumor which makes fine needle aspiration cytology unreliable. Histopathological review of the tumor is essential for diagnosis. Pancreatoblastomas should be considered a differential diagnosis of solid and cystic pancreatic neoplasms. Surgical resection of the tumor is the treatment of choice with a variable combination with radiotherapy and chemotherapy.

摘要

胰腺母细胞瘤(PB)是一种病因不明的罕见胰腺恶性肿瘤。它主要发生在儿童人群中,成人病例极为罕见。本文对文献中成人胰腺母细胞瘤的病例报告进行了综述。共确定并回顾了35例病例,平均年龄41岁(范围18 - 78岁),男性占病例的51.4%。成人胰腺母细胞瘤似乎好发于胰头,在所回顾的病例中约占49%,平均大小为8厘米(范围1.8 - 20厘米)。患者的中位随访时间为15个月(范围1 - 108个月)。转移性疾病和周围组织的局部浸润在成人患者中很常见,预后较差。由于成人中肿瘤标志物无诊断价值且肿瘤细胞异质性使得细针穿刺细胞学检查不可靠,术前诊断困难。肿瘤的组织病理学检查对诊断至关重要。胰腺母细胞瘤应被视为实性和囊性胰腺肿瘤的鉴别诊断之一。手术切除肿瘤是首选治疗方法,可与放疗和化疗联合应用。

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