De Silva W S L, Pathirana A A, Prematilleke I, Rajapakse S A P D, Hettiarachchi P S H, Manawasinghe D S, Dassanayake B K
Post Graduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka.
Department of Surgery, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Colombo, Sri Lanka.
J Med Case Rep. 2017 Mar 28;11(1):84. doi: 10.1186/s13256-017-1244-0.
Only a limited number of multiple synchronous primary malignancies of the pancreas have been reported in the medical literature. We report a case of two solid malignant tumors of the pancreas diagnosed preoperatively.
We describe a 65-year-old Sri Lankan woman who presented with progressive obstructive jaundice. Initial contrast-enhanced computed tomography imaging detected a malignant tumor at the tail of her pancreas. A second tumor of the pancreatic head was detected with integrated imaging using multidetector computed tomography and multimodal magnetic resonance imaging. She underwent total pancreaticoduodenectomy and splenectomy. Gross examination of the specimen confirmed the presence of two separate tumors. Histology of the ampullary tumor showed pancreatic-type adenocarcinoma and the tumor in the tail of her pancreas showed a colloid-type adenocarcinoma.
The possibility of multiple primary malignant solid tumors of different types with malignant potential has to be considered even without background pathology when managing multiple tumors in the pancreas.
医学文献中报道的胰腺多原发同步恶性肿瘤数量有限。我们报告一例术前诊断为胰腺两个实性恶性肿瘤的病例。
我们描述了一名65岁的斯里兰卡女性，她因进行性梗阻性黄疸就诊。最初的增强计算机断层扫描成像在她的胰尾部发现了一个恶性肿瘤。使用多排探测器计算机断层扫描和多模态磁共振成像的综合成像检测到胰头部有第二个肿瘤。她接受了全胰十二指肠切除术和脾切除术。标本的大体检查证实存在两个独立的肿瘤。壶腹肿瘤的组织学检查显示为胰腺型腺癌，胰尾部的肿瘤显示为胶样腺癌。
在处理胰腺多发肿瘤时，即使没有背景病理情况，也必须考虑存在具有恶性潜能的不同类型多原发恶性实性肿瘤的可能性。
