Matsui Hiroto, Sakamoto Kazuhiko, Matsukuma Satoshi, Tokumitsu Yukio, Tokuhisa Yoshihiro, Kanekiyo Shinsuke, Tomochika Shinobu, Iida Michihisa, Suzuki Nobuaki, Takeda Shigeru, Yoshino Shigefumi, Hazama Shoichi, Ueno Tomio, Nagano Hiroaki
Dept. of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2017 Nov;44(12):1235-1237.
The patient was a 46-year-old woman with left lower abdominal pain.Abdominal dynamic CT revealed a 40 mm, gradually- enhanced pancreatic head mass.The interior of the tumor was heterogeneous and partly low in density.Endoscopic ultrasonography showed a well-defined and heterogeneous tumor with an echoic area in the pancreatic head.Therefore, the cystic lesion with solid components was suspected to be a solid pseudopapillary neoplasm(SPN), considering the age of the patient.Subtotal stomach-preserving pancreaticoduodenectomy was performed.The postoperative course was uneventful, and she was discharged on the 13th day after surgery.Postoperative pathology confirmed a diagnosis of pancreatic acinar cell carcinoma.SPNs often show an image very similar to pancreatic acinar cell carcinoma and it is difficult to distinguish between the two only by imaging findings.Due to the divergence between clinical findings such as age and image findings, it was difficult to confirm a diagnosis of pancreatic acinar cell carcinoma in this case.
该患者为一名46岁的女性，有左下腹疼痛症状。腹部动态CT显示胰头有一个40毫米、逐渐强化的肿块。肿瘤内部不均匀，部分密度较低。内镜超声显示胰头有一个边界清晰、不均匀的肿瘤，并有一个回声区。考虑到患者年龄，怀疑这个有实性成分的囊性病变为实性假乳头状肿瘤（SPN）。遂进行了保留部分胃的胰十二指肠切除术。术后病程顺利，患者在术后第13天出院。术后病理确诊为胰腺腺泡细胞癌。SPN通常表现出与胰腺腺泡细胞癌非常相似的影像，仅通过影像学表现很难区分两者。由于年龄等临床症状与影像表现之间存在差异，该病例很难确诊为胰腺腺泡细胞癌。
