Suzuki Atomu, Matsui Hiroto, Tokumitsu Yukio, Shindou Yoshitarou, Matsukuma Satoshi, Nakajima Masao, Tomochika Shinobu, Yoshida Shin, Iida Michihisa, Suzuki Nobuaki, Takeda Shigeru, Yoshino Shigefumi, Hazama Shouichi, Nagano Hiroaki
Dept. of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2020 Dec;47(13):1921-1923.
The patient was a woman in her 80s. Operative treatment was performed for papillary thyroid cancer(pT3N0M0)13 years ago. A follow-up CT scan 1 year ago revealed a skin, lung, and lymph node metastasis. At the same time, a tumor with a size of 24 mm was initially observed in the tail of the pancreas, which was considered to be pancreatic metastasis of thyroid papillary cancer and was followed up. Only the pancreatic lesions tended to gradually increase, although other lesions did not increase. Therefore, the patient was referred to our department. It was difficult to diagnose preoperatively. Thus, diagnostic and therapeutic laparoscopic distal pancreatectomy with splenectomy was performed. The pathological diagnosis was dedifferentiated liposarcoma. Postoperatively, a Grade B pancreatic fistula was observed, but the patient recovered conservatively and was discharged on postoperative day 55. Primary liposarcoma of the pancreas is extremely rare, and few cases have been reported. Primary liposarcoma of the pancreas is very difficult to diagnose preoperatively by only diagnostic imaging.
患者为一名80多岁的女性。13年前因甲状腺乳头状癌(pT3N0M0)接受了手术治疗。1年前的一次随访CT扫描显示有皮肤、肺部和淋巴结转移。同时,最初在胰尾部观察到一个大小为24 mm的肿瘤,考虑为甲状腺乳头状癌的胰腺转移,并对其进行了随访。尽管其他病变没有增大,但只有胰腺病变有逐渐增大的趋势。因此,该患者被转诊至我科。术前诊断困难。于是,实施了诊断性和治疗性腹腔镜远端胰腺切除术并脾切除术。病理诊断为去分化脂肪肉瘤。术后观察到B级胰瘘,但患者经保守治疗后康复,并于术后第55天出院。胰腺原发性脂肪肉瘤极为罕见,报道的病例很少。仅通过诊断性影像学检查很难在术前诊断胰腺原发性脂肪肉瘤。