From the Division of Surgical Oncology, Department of Surgery.
Department of Radiology and Biomedical Imaging.
Pancreas. 2021 Mar 1;50(3):434-440. doi: 10.1097/MPA.0000000000001785.
The incidence of pancreatic cystic neoplasms has grown because of increased detection. Among these lesions, serous cystadenoma was traditionally thought to be universally benign and indolent. However, there is an exceedingly rare malignant variant of serous cystadenoma known as serous cystadenocarcinoma (SCAC) that can exhibit local invasion into adjacent structures, hepatic implants, and metastatic spread to the abdominal viscera. Diagnosis of SCAC can be challenging as it is histologically identical to serous cystadenoma. To better understand this entity, a review of all published accounts of SCAC was performed in which tumor and patient factors were characterized. In addition, we present the case of a 49-year-old woman who was found to have a solitary hepatic metastasis due to SCAC, 11 years after a distal pancreatectomy for serous cystadenoma. She was successfully treated with percutaneous microwave ablation and has no evidence of recurrence 3 years later. This report details the first published account of percutaneous ablation in such a setting. Compared with hepatectomy, hepatic ablation may offer a less invasive but equally effective treatment option in well-selected patients.
由于检测的增加，胰腺囊性肿瘤的发病率有所上升。在这些病变中，浆液性囊腺瘤传统上被认为是普遍良性和惰性的。然而，有一种极其罕见的浆液性囊腺癌（SCAC）恶性变体，它可以表现为局部侵犯相邻结构、肝种植和转移性扩散到腹部内脏。SCAC 的诊断具有挑战性，因为它在组织学上与浆液性囊腺瘤相同。为了更好地了解这种实体，我们对所有已发表的 SCAC 病例进行了回顾，其中对肿瘤和患者因素进行了特征描述。此外，我们还介绍了一位 49 岁女性的病例，她在因浆液性囊腺瘤行远端胰腺切除术 11 年后，因 SCAC 发现单发肝转移。她成功接受了经皮微波消融治疗，3 年后无复发迹象。本报告详细介绍了首例经皮消融治疗此类病变的病例。与肝切除术相比，在选择合适的患者中，肝消融可能提供一种创伤性更小但同样有效的治疗选择。
