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胰腺成熟囊性畸胎瘤与其模仿物的诊断与鉴别:一例报告

Diagnosis and differentiation of mature cystic teratoma of pancreas from its mimics: A case report.

作者信息

Zhou Xin He, Ma Ji Kong, Valluru Bimbadhar, Sharma Kalyan, Liu Ling, Hu Jin Bo

机构信息

Department of Radiology, the First Affiliated Hospital of Dali University.

Department of Nephrology, Dali Bai Autonomous Prefecture People's Hospital Dali 671000, China.

出版信息

Medicine (Baltimore). 2020 Nov 20;99(47):e23267. doi: 10.1097/MD.0000000000023267.

Abstract

INTRODUCTION

Mature cystic teratoma originating in the pancreas is very unusual, often observed as an incidental finding during routine examinations or recognized perioperatively as the patients present with very unspecific clinical symptoms. The confirmatory diagnosis of a pancreatic cystic teratoma is generally made by histopathology after surgical excision. So, the preoperative diagnosis is very challenging, especially differentiation from the other pancreatic pathologies.

PATIENT CONCERNS

A 23-year-old woman was admitted to our hospital with a complaint of mild grade periumbilical abdominal pain. A pancreatic mass was revealed on a preliminary abdominal ultrasound examination. Her medical history was unremarkable with no long-standing illness or malignancy.

DIAGNOSIS

Mature cystic teratoma in the head of the pancreas.

INTERVENTIONS

Roux-enY choledochojejunostomy with gastrojejunostomy was performed, excising the tumor from the pancreatic head.

OUTCOMES

The postoperative course was uneventful; the patient was asymptomatic and has no evidence of recurrence on a 2-year follow up.

CONCLUSIONS

Pancreatic cystic teratoma is a benign, well-differentiated, and extremely rare congenital tumor. MRI is the choice of imaging modality and phase-GRE or fat suppression is the best technique for pre-operative diagnosis.

摘要

引言

起源于胰腺的成熟囊性畸胎瘤非常罕见,常在常规检查中偶然发现,或在手术中因患者临床表现非常不特异而被识别。胰腺囊性畸胎瘤的确诊通常在手术切除后通过组织病理学检查做出。因此,术前诊断极具挑战性,尤其是与其他胰腺病变的鉴别。

患者情况

一名23岁女性因轻度脐周腹痛入院。初步腹部超声检查发现胰腺有肿块。她的病史无异常,无长期疾病或恶性肿瘤史。

诊断

胰腺头部成熟囊性畸胎瘤。

干预措施

行 Roux-enY 胆总管空肠吻合术加胃空肠吻合术,从胰头切除肿瘤。

结果

术后过程顺利;患者无症状,2年随访无复发迹象。

结论

胰腺囊性畸胎瘤是一种良性、分化良好且极其罕见的先天性肿瘤。MRI 是影像学检查的首选,相位梯度回波(phase-GRE)或脂肪抑制是术前诊断的最佳技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6636/7676578/27084a5e2e2e/medi-99-e23267-g001.jpg

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