[一例远端胆管癌转化为神经内分泌癌并扩散至胰腺的病例]
[A case of distal bile duct carcinoma converted to neuroendocrine cancer and proliferated into the pancreas].
作者信息
Nakao Mitsuhiro, Honjo Mitsuyoshi, Fujita Mitsuru, Tanaka Reina, Ishii Kentaro, Tsuchiya Takayoshi, Sofuni Atsushi, Nagakawa Yuichi, Yamaguchi Hiroshi, Itoi Takao
机构信息
Department of Gastroenterology and Hepatology, Tokyo Medical University.
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University.
出版信息
Nihon Shokakibyo Gakkai Zasshi. 2021;118(2):168-174. doi: 10.11405/nisshoshi.118.168.
A woman in her 50s was referred due to a solid mass in the head of the pancreas. It was diagnosed as a neuroendocrine carcinoma (NEC) by endoscopic ultrasound-guided fine-needle aspiration. Consequently, pancreatoduodenectomy was performed. A well-differentiated adenocarcinoma component was revealed in the resected bile duct, suggesting a relationship with the NEC component in the pancreas. Genetic examination suggested that cholangiocarcinoma, but not coexisting carcinoma, was converted to NEC after the interstitial invasion. Finally, it was diagnosed as the NEC derived from the extrahepatic bile duct, which is rare at about 0.2-2% in gastrointestinal neuroendocrine neoplasms.
一名50多岁的女性因胰头实性肿块前来就诊。经内镜超声引导下细针穿刺活检，诊断为神经内分泌癌（NEC）。随后进行了胰十二指肠切除术。切除的胆管中发现了高分化腺癌成分，提示其与胰腺中的NEC成分有关。基因检测表明，胆管癌而非并存癌在间质浸润后转变为NEC。最终，诊断为起源于肝外胆管的NEC，在胃肠道神经内分泌肿瘤中较为罕见，发生率约为0.2%-2%。
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