Zhang Meng-Yu, Tian Bo-Le
Department of Pancreatic Surgery, West China Hospital/West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Clin Cases. 2018 Dec 6;6(15):1036-1041. doi: 10.12998/wjcc.v6.i15.1036.
Solid pseudopapillary tumor of the pancreas (SPTP), also known as solid and papillary epithelial neoplasm of the pancreas, is a rare pancreatic exocrine tumor that is difficult to diagnose before surgery. Pancreatic panniculitis is a rare type that occurs in less than 3% of all patients with pancreatic diseases. We here report a 19-year-old woman who presented with persistent left upper quadrant pain without obvious cause for 1 d. The patient also developed subcutaneous nodules involving lower abdomen bilaterally and lower limbs, and subcutaneous nodules were pathologically diagnosed as pancreatic panniculitis. Plain abdominal computed tomography revealed a soft-tissue mass in the body and tail of the pancreas, which was closely associated with the gastric wall. Contrast-enhanced ultrasound showed inhomogeneous echogenicity in the anterior pancreatic body, which had blurred parenchymal demarcation of the body and tail of the pancreas. Contrast-enhanced abdominal computed tomography revealed a mixed density mass with solid and cystic components in the body and tail of the pancreas, and the solid component was markedly enhanced. The lesion was pathologically diagnosed as SPTP after laparoscopic resection. Clinicians should be aware of the clinical manifestation, diagnosis, and treatment of pancreatic panniculitis and SPTP.
胰腺实性假乳头状瘤（SPTP），也称为胰腺实性和乳头状上皮性肿瘤，是一种罕见的胰腺外分泌肿瘤，术前难以诊断。胰腺脂膜炎是一种罕见类型，在所有胰腺疾病患者中发生率不到3%。我们在此报告一名19岁女性，她无明显原因持续左上腹疼痛1天。患者双侧下腹部和下肢还出现皮下结节，皮下结节经病理诊断为胰腺脂膜炎。腹部平扫计算机断层扫描显示胰腺体尾部有一软组织肿块，与胃壁密切相关。超声造影显示胰腺体部前方回声不均匀，胰腺体尾部实质分界不清。腹部增强计算机断层扫描显示胰腺体尾部有一实性和囊性成分的混合密度肿块，实性成分明显强化。经腹腔镜切除后，病变经病理诊断为SPTP。临床医生应了解胰腺脂膜炎和SPTP的临床表现、诊断及治疗。
