Nakashima Shinsuke, Yamada Terumasa, Sato Go, Sakai Takaaki, Chinen Yoshinao, Itakura Hiroaki, Kato Ryo, Ueda Masami, Tsuda Yujiro, Ohta Katsuya, Matsuyama Jin, Ikenaga Masakazu
Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan.
Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan.
Int J Surg Case Rep. 2019;54:83-86. doi: 10.1016/j.ijscr.2018.11.060. Epub 2018 Nov 27.
Enteric duplication cysts are rare and, in addition, isolated enteric duplication cysts are lower morbidity prevalence rate. These cysts lack a connection to the gastrointestinal tract or the adjacent mesenteric vasculature and have only been reported in 10 case reports. In these reports, only two reports were cases with malignant transformation. Our case was a report for the advanced cancer of the isolated enteric duplication cyst.
The patient was a 43 year-old woman with slightly abdominal pain and mass formation. The abdominal contrast-enhanced computed tomography showed 130 × 100 × 90 mm huge cystic mass existed in right upper peritoneal cavity. The cystic mass had thickened wall and many enhanced nodules. As these imaging findings suggested a tumor originated from pancreas and the preoperative diagnose was suspect of mucinous cystic neoplasm. In operative findings, the tumor originated from pancreatic head and did not attach to gastrointestinal tract. Final pathology indicated the cyst was an isolated advanced enteric duplication cyst cancer and not originated from pancreas.
We experienced an extremely rare case of completely isolated advanced enteric duplication cyst cancer. Unique to this case, the preoperative diagnosis was suspect of mucinous cystic neoplasm arising from pancreas head and partial pancreatectomy was performed. However, in the pathological findings, this cyst diagnosed advanced enteric duplication cyst cancer.
肠重复囊肿较为罕见，此外，孤立性肠重复囊肿的发病率更低。这些囊肿与胃肠道或相邻的肠系膜血管系统无连接，仅有10例病例报告。在这些报告中，仅有2例为恶变病例。我们的病例是一例孤立性肠重复囊肿晚期癌症的报告。
患者为一名43岁女性，有轻微腹痛和肿块形成。腹部增强计算机断层扫描显示右上腹膜腔内存在一个130×100×90mm的巨大囊性肿块。囊性肿块壁增厚，有许多强化结节。由于这些影像学表现提示肿瘤起源于胰腺，术前诊断怀疑为黏液性囊性肿瘤。手术所见，肿瘤起源于胰头，未附着于胃肠道。最终病理显示该囊肿为孤立性晚期肠重复囊肿癌，并非起源于胰腺。
我们遇到了一例极为罕见的完全孤立性晚期肠重复囊肿癌病例。该病例的独特之处在于，术前诊断怀疑为胰头黏液性囊性肿瘤并进行了部分胰腺切除术。然而，病理结果显示该囊肿诊断为晚期肠重复囊肿癌。
