Chang James M, Katariya Nitin N, Lam-Himlin Dora M, Haakinson Danielle J, Ramanathan Ramesh K, Halfdanarson Thorvardur R, Borad Mitesh J, Pannala Rahul, Faigel Douglas, Moss Adyr A, Mathur Amit K
Division of Transplant and Hepatopancreatobiliary Surgery, Mayo Clinic Arizona, Phoenix, Ariz., USA.
Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, Ariz., USA.
Case Rep Gastroenterol. 2016 Oct 18;10(3):605-612. doi: 10.1159/000448064. eCollection 2016 Sep-Dec.
Fewer than 25 cases of hepatoid carcinoma of the pancreas have been reported in the literature. We present a case in a 61-year-old male with a remote history of Hodgkin's lymphoma and gastric neuroendocrine cell hyperplasia. On surveillance endoscopic ultrasound, an 8 × 5 mm cystic lesion was seen in the tail of the pancreas. MRI showed a focal pancreatic duct cut-off with mild ductal dilation. Fine needle aspiration was performed, which was concerning for acinar cell carcinoma. The patient underwent distal pancreatectomy and recovered uneventfully. Final pathology demonstrated a 1.3-cm hepatoid carcinoma of the pancreas, with a final clinicopathological stage of T1N0M0. Next-generation nucleic acid sequencing of the tumor did not suggest a viable adjuvant chemotherapeutic agent, and no adjuvant therapy was administered. The patient has no evidence of disease 6 months following resection. A further characterization and description of the outcomes of these rare tumors is warranted to help guide providers and counsel patients.
文献报道的胰腺肝样癌病例少于25例。我们报告一例61岁男性病例,该患者有霍奇金淋巴瘤和胃神经内分泌细胞增生的既往史。在监测性内镜超声检查中,胰腺尾部发现一个8×5毫米的囊性病变。磁共振成像显示胰腺导管局部截断,伴有轻度导管扩张。进行了细针穿刺抽吸,结果提示为腺泡细胞癌。患者接受了远端胰腺切除术,术后恢复顺利。最终病理显示为1.3厘米的胰腺肝样癌,最终临床病理分期为T1N0M0。肿瘤的下一代核酸测序未提示有可行的辅助化疗药物,因此未给予辅助治疗。切除术后6个月,患者无疾病证据。有必要对这些罕见肿瘤的结果进行进一步的特征描述,以帮助指导医护人员并为患者提供咨询。