Kumar S, Raobiakady R, Watkins D, Terlizzo M, Bhogal R H
The Royal Marsden Hospital (NHS Foundation Trust), Department of Surgery, Fulham Road, Chelsea, London, SW3 6JJ, United Kingdom; Division of Radiotherapy & Imaging, The Institute for Cancer Research, 123 Old Brompton Road, London, United Kingdom; Imperial College London, Department of Surgery & Cancer, Exhibition Road, South Kensington, London, SW7 2BU, United Kingdom.
The Royal Marsden Hospital (NHS Foundation Trust), Department of Anaesthetics, Fulham Road, Chelsea, London, SW3 6JJ, United Kingdom.
Int J Surg Case Rep. 2021 Apr;81:105724. doi: 10.1016/j.ijscr.2021.105724. Epub 2021 Mar 5.
There are limited reports in the literature of radical surgical resection for pancreatic neuroendocrine carcinoma (PNEC). In patients with non-functioning PNEC (NF-PNEC) within the tail of the pancreas tumours can cause splenic vein thrombosis (SVT) and subsequent sinitral portal hypertension (SPH). Radical surgical resection in such patients with concomitant liver metastasis has not previously been reported.
We present a 67-year old female patient who presented with a large NF-PNEC within the tail of the pancreas with liver metastasis. We performed a distal pancreatectomy, splenectomy, partial gastrectomy and liver resection to achieve radical resecton.
All patients with NF-PNEC within the tail of the pancreatic should be considered for radical surgical resection. In the presence of multi-visceral involvement and complications such as SVT and/or SPH multi-speciality surgical expertise is likely to be required.
Radical multi-visceral resection for large NF-PNEC can be safely performed in the presence of SVT and SPH.
关于胰腺神经内分泌癌（PNEC）根治性手术切除的文献报道有限。对于胰腺尾部无功能性PNEC（NF-PNEC）患者，肿瘤可导致脾静脉血栓形成（SVT）及随后的左侧门静脉高压（SPH）。此前尚无关于此类伴有肝转移患者进行根治性手术切除的报道。
我们报告一名67岁女性患者，其胰腺尾部有一个伴有肝转移的大型NF-PNEC。我们进行了胰体尾切除术、脾切除术、部分胃切除术和肝切除术以实现根治性切除。
所有胰腺尾部NF-PNEC患者均应考虑进行根治性手术切除。在存在多脏器受累及SVT和/或SPH等并发症的情况下，可能需要多专科手术专业知识。
在存在SVT和SPH的情况下，可安全地对大型NF-PNEC进行根治性多脏器切除。
