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酷似其他胰腺肿瘤的胰腺脂肪瘤样错构瘤:1例报告及文献复习

Pancreatic lipomatous hamartoma mimicking other pancreatic tumor: a case report and literature review.

作者信息

Zhou Bo, Li Guogang, Xu Shaoyan, Zhan Canyang, Zheng Xiang, Yan Sheng

机构信息

Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine Hangzhou, China.

Department of Neonatology, Children's Hospital, School of Medicine, Zhejiang University Hangzhou, China.

出版信息

Am J Transl Res. 2020 Oct 15;12(10):6682-6688. eCollection 2020.

Abstract

Pancreatic lipomatous hamartoma (PLH) is an extremely rare benign entity that forms a mass-like lesion. PLH lacks distinct features, and can be preoperatively misdiagnosed as a pancreatic tumor with lipomatous components, including pancreatic lipomatosis, lipoma, liposarcoma, and malignant tumors with fatty degeneration. Here, we report a case study of PLH in a 73-year-old male who presented with abdominal pain. Abdominal-enhanced computed tomography and magnetic resonance imaging revealed a 4.3×4-cm solid mass with a lipomatous component in the pancreatic head, and the mass displayed a centripetal pattern of contrast enhancement. The patient was preoperatively diagnosed with pancreatic liposarcoma, and subsequently underwent a pancreatoduodenectomy. The postoperative pathology and immunohistochemical analyses confirmed the diagnosis of PLH, which primarily contained mature adipocytes, small ducts, and a few well-preserved pancreatic acini. Although this disease is rare, we suggest that PLH should be considered during the differential diagnosis of pancreatic lesions with lipomatous components. Consideration of the potential for PLH disease might reduce the number of unnecessary resections.

摘要

胰腺脂肪瘤样错构瘤(PLH)是一种极其罕见的良性病变,可形成肿块样病灶。PLH缺乏明显特征,术前可能被误诊为具有脂肪瘤样成分的胰腺肿瘤,包括胰腺脂肪沉积症、脂肪瘤、脂肪肉瘤以及伴有脂肪变性的恶性肿瘤。在此,我们报告一例73岁男性PLH病例,该患者表现为腹痛。腹部增强计算机断层扫描和磁共振成像显示胰头部有一个4.3×4厘米的实性肿块,伴有脂肪瘤样成分,且该肿块呈现向心性强化模式。患者术前被诊断为胰腺脂肪肉瘤,随后接受了胰十二指肠切除术。术后病理及免疫组化分析确诊为PLH,其主要包含成熟脂肪细胞、小导管和一些保存完好的胰腺腺泡。尽管这种疾病罕见,但我们建议在鉴别诊断具有脂肪瘤样成分的胰腺病变时应考虑PLH。考虑到PLH疾病的可能性可能会减少不必要的切除术数量。

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