Demesmaker Vincent, Abou-Messaoud Faouzi, Parent Muriel, Vanhoute Bernard, Maassarani Fadi, Kothonidis Konstantinos
CHR Val de Sambre, Auvelais, Belgium.
IPG, Gosselies, Belgium.
J Surg Case Rep. 2019 Dec 17;2019(12):rjz360. doi: 10.1093/jscr/rjz360. eCollection 2019 Dec.
Although many types of pancreatic tumors exist, pancreatic solid serous cystadenoma stand as the most rare. Despite advances in medical imaging, definitive diagnosis remains complex. Here, we report a case of a 63-year-old man with a suspicious lesion of the pancreas discovered during a positron emission tomography-computed tomography. Despite an echo-endoscopy being performed, no biopsies were contributive. The magnetic resonance imaging did highlight another lesion in the liver. Due to the suspicion of a neuroendocrine tumor of the pancreas with liver metastases, a cephalic duodenopancreatectomy with partial hepatectomy was performed. During the procedure, another hepatic lesion was resected. The final histological diagnosis was a serous solid adenoma of the pancreas associated with a cholangiocarcinoma. During the follow-up, the patient presented a massive metastatic hepatic relapse even after the administration of a palliative chemotherapy.
尽管存在多种类型的胰腺肿瘤,但胰腺实性浆液性囊腺瘤是最为罕见的。尽管医学影像学取得了进展,但明确诊断仍然复杂。在此,我们报告一例63岁男性病例,其在正电子发射断层扫描-计算机断层扫描检查中发现胰腺有可疑病变。尽管进行了超声内镜检查,但活检未提供有价值的信息。磁共振成像确实显示肝脏有另一处病变。由于怀疑胰腺神经内分泌肿瘤伴肝转移,遂行胰头十二指肠切除术及部分肝切除术。手术过程中,切除了另一处肝脏病变。最终组织学诊断为胰腺浆液性实性腺瘤合并胆管癌。随访期间,即使给予姑息化疗,患者仍出现了大量肝转移复发。