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胰腺成熟囊性畸胎瘤伴30年临床病程:一例报告

Mature cystic teratoma of the pancreas with 30 years of clinical course: A case report.

作者信息

Li Zhi, Ke Nengwen, Liu Xubao, Gong Shu

机构信息

Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu, China.

出版信息

Medicine (Baltimore). 2018 Apr;97(15):e0405. doi: 10.1097/MD.0000000000010405.

Abstract

RATIONALE

Mature cystic teratoma of the pancreas is an extremely rare condition that is challenging to manage due to inadequate preoperative histological diagnosis.

PATIENT CONCERNS

A 36-year-old female was admitted to our hospital because of a complaint of worsening paroxysmal abdominal pain for over a year. She was diagnosed with pancreatic pseudocyst and underwent five surgical procedures (i.e., four external drainage and one internal drainage procedures) in the last 30 years.

DIAGNOSES

Intraoperative frozen section analysis identified the tumor as a cystic teratoma, and pathological evaluation confirmed it to be a mature cystic teratoma.

INTERVENTIONS

Explorative laparotomy was performed, and the tumor was then resected completely through with partial pancreatectomy, left colon resection, partial gastrectomy, duodenectomy, as well as inferior vena cava and renal vascular repair.

OUTCOMES

The patient exhibited a generally good wellbeing without any recurrence during the 6 months of follow up.

LESSONS

This case demonstrated the significant impacts of misdiagnosis and inappropriate treatments for benign disease on the patient's quality of life and highlighted the importance of early surgical resection with a definitive pathological diagnosis for pancreatic cystic teratoma.

摘要

理论依据

胰腺成熟囊性畸胎瘤是一种极为罕见的疾病,由于术前组织学诊断不足,其治疗具有挑战性。

患者情况

一名36岁女性因阵发性腹痛加重一年余入院。她被诊断为胰腺假性囊肿,在过去30年里接受了五次外科手术(即四次外引流和一次内引流手术)。

诊断

术中冰冻切片分析确定肿瘤为囊性畸胎瘤,病理评估证实为成熟囊性畸胎瘤。

干预措施

进行了剖腹探查术,然后通过部分胰腺切除术、左结肠切除术、部分胃切除术、十二指肠切除术以及下腔静脉和肾血管修复术将肿瘤完全切除。

结果

患者在6个月的随访期间总体状况良好,无任何复发。

经验教训

该病例表明良性疾病的误诊和不恰当治疗对患者生活质量有重大影响,并强调了早期手术切除并获得明确病理诊断对于胰腺囊性畸胎瘤的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d47/5908556/6034db71fee0/medi-97-e0405-g001.jpg

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