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胰腺转移性腺泡细胞癌中的胰腺脂膜炎与血清脂肪酶升高：一例报告并文献复习

Pancreatic panniculitis and elevated serum lipase in metastasized acinar cell carcinoma of the pancreas: A case report and review of literature.

作者信息

Miksch Rainer Christoph, Schiergens Tobias S, Weniger Maximilian, Ilmer Matthias, Kazmierczak Philipp M, Guba Markus O, Angele Martin K, Werner Jens, D'Haese Jan G

机构信息

Department of General, Visceral, and Transplantation Surgery, Ludwig-Maximilians-University Munich, Munich 81377, Bavaria, Germany.

Department of General Visceral Transplantat Vasc & Thorac Surg, Campus Grosshadern, University of Munich, Munich 81377, Germany.

出版信息

World J Clin Cases. 2020 Nov 6;8(21):5304-5312. doi: 10.12998/wjcc.v8.i21.5304.

DOI:10.12998/wjcc.v8.i21.5304
PMID:33269263
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7674712/
Abstract

BACKGROUND

Pancreatic panniculitis is an extremely rare condition associated with different underlying pancreatic disorders and characterized by subcutaneous fat necrosis induced by elevated serum lipase levels. These lesions usually affect the lower extremities and may precede abdominal symptoms of pancreatic disease. Acinar cell carcinoma (ACC) of the pancreas is a rare pancreatic neoplasm, accounting for only 1%-2% of pancreatic tumors in adults.

CASE SUMMARY

We present the case of a 72-year-old man with ACC of the pancreatic head and synchronous liver metastases. Both the primary tumor and liver metastases were resected. Serum lipase was elevated before surgery and decreased to normal postoperatively. Rising serum lipase levels at follow-up led to the diagnosis of hepatic recurrence. This disease progression was then accompanied by pancreatic panniculitis, with subcutaneous fat necrosis and acute arthritis. To the best of our knowledge, only 4 cases have been reported in the literature and each showed a similar association of serum lipase levels with pancreatic panniculitis and progression of ACC.

CONCLUSION

Clinical symptoms and progression of ACC may correlate with serum lipase levels, suggesting potential usefulness as a follow-up biomarker.

摘要

背景

胰腺性脂膜炎是一种极其罕见的疾病，与不同的潜在胰腺疾病相关，其特征是血清脂肪酶水平升高导致皮下脂肪坏死。这些病变通常累及下肢，且可能先于胰腺疾病的腹部症状出现。胰腺腺泡细胞癌（ACC）是一种罕见的胰腺肿瘤，仅占成人胰腺肿瘤的1%-2%。

病例摘要

我们报告一例72岁男性患者，患有胰头ACC并伴有同步肝转移。原发肿瘤和肝转移灶均被切除。术前血清脂肪酶升高，术后降至正常。随访时血清脂肪酶水平升高导致肝复发的诊断。这种疾病进展随后伴有胰腺性脂膜炎，出现皮下脂肪坏死和急性关节炎。据我们所知，文献中仅报道了4例，且每例均显示血清脂肪酶水平与胰腺性脂膜炎及ACC进展存在类似关联。

结论

ACC的临床症状和进展可能与血清脂肪酶水平相关，提示其作为随访生物标志物具有潜在用途。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/662e67dcbbe9/WJCC-8-5304-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/b6ea3a4bbbae/WJCC-8-5304-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/35f2ba02a498/WJCC-8-5304-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/2128972118d4/WJCC-8-5304-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/d62ddfae924f/WJCC-8-5304-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/662e67dcbbe9/WJCC-8-5304-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/b6ea3a4bbbae/WJCC-8-5304-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/35f2ba02a498/WJCC-8-5304-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/2128972118d4/WJCC-8-5304-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/d62ddfae924f/WJCC-8-5304-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30b/7674712/662e67dcbbe9/WJCC-8-5304-g005.jpg

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