Carvalho Lúcia, Ferreira Tiago, Frutuoso Luísa, Matos Leonor, Castro Tiago, Rodrigues Domingos, Oliveira Vera, Gonçalves Gil, Nora Mário, Scigliano Horácio
Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
Anatomical Pathology Laboratory Dr. Albino Oliveira (Unilabs), Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
J Surg Case Rep. 2020 Jul 8;2020(7):rjaa085. doi: 10.1093/jscr/rjaa085. eCollection 2020 Jul.
Mucinous cystic neoplasms (MCNs) of the pancreas occurring during pregnancy constitute a rare condition requiring special management due to its large size, malignant potential and the risk of fetal growth restriction. The key points to manage MCNs are to perform a correct diagnosis, accurately evaluate the grade of malignant potential in order to establish the right time for pancreatic surgery and to choose the most appropriate fetal mode of delivery. We describe a case of an incidental abdominal mass detected in a third-trimester pregnant woman. At surgery, a huge pancreatic cystic tumour was found and a distal pancreatectomy with splenic preservation was performed. The histopathological analysis revealed an MCN of the pancreas with low-grade dysplasia. To our knowledge, this is the largest pancreatic MCN detected in a pregnant woman reported in the literature and one of the few successfully resected after vaginal delivery.
孕期发生的胰腺黏液性囊性肿瘤（MCNs）是一种罕见情况，因其体积大、有恶变潜能以及存在胎儿生长受限风险，需要特殊处理。处理MCNs的关键点在于进行正确诊断，准确评估恶变潜能等级，以确定胰腺手术的合适时机，并选择最合适的胎儿分娩方式。我们描述了一例在孕晚期孕妇中偶然发现的腹部肿块病例。手术时，发现一个巨大的胰腺囊性肿瘤，并进行了保留脾脏的胰体尾切除术。组织病理学分析显示为低级别发育异常的胰腺MCN。据我们所知，这是文献报道中在孕妇中检测到的最大的胰腺MCN，也是少数在阴道分娩后成功切除的病例之一。
