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胰腺实性假乳头状瘤的远端胰腺切除术:病例报告

Distal Pancreatectomy for Solid Pseudopapillary Tumor of the Pancreas: A Case Report.

作者信息

Guimaraes Narcisa, Vila Nova Carlos, Oliveira Dias Raquel, Fonseca Pinho Joao, Valente Cecílio José

机构信息

General Surgery, Hospital Distrital da Figueira da Foz, Figueira da Foz, PRT.

出版信息

Cureus. 2021 Nov 25;13(11):e19880. doi: 10.7759/cureus.19880. eCollection 2021 Nov.

Abstract

Solid pseudopapillary tumor (SPT) of the pancreas is a rare tumor, sometimes asymptomatic, mainly affecting young females. It has a low malignant potential, and its complete surgical resection with free margins is the treatment of choice, offering an excellent prognosis. We present the case of a 43-year-old healthy female who was referred to the surgery department for a large abdominal mass found in the abdominal ultrasound. In the course of the study of this mass, an abdominal CT with fine needle aspiration (FNA) was performed, revealing a solid pseudopapillary tumor of the tail of the pancreas. A laparotomic distal pancreatectomy with total splenectomy was performed. A grade B pancreatic fistula occurred on the third postoperative day, and she was released on postoperative day 11. Histopathology study revealed a 10 cm solid pseudopapillary tumor of the pancreas, with cavities filled with hematic content and limited by a partially calcified capsule. SPT is a rare and indolent tumor. Prognosis is highly favorable after an adequate surgical resection, hence the importance of a precise preoperative diagnosis. Therefore, it is important to choose the most appropriate surgical strategy for each patient.

摘要

胰腺实性假乳头状瘤(SPT)是一种罕见肿瘤,有时无症状,主要影响年轻女性。其恶性潜能较低,完整手术切除且切缘阴性是首选治疗方法,预后良好。我们报告一例43岁健康女性病例,该患者因腹部超声检查发现腹部有一巨大肿块而被转诊至外科。在对该肿块的检查过程中,进行了腹部CT及细针穿刺活检(FNA),结果显示为胰腺尾部实性假乳头状瘤。遂行剖腹远端胰腺切除术及全脾切除术。术后第3天发生了B级胰瘘,患者于术后第11天出院。组织病理学检查显示胰腺有一个直径10 cm的实性假乳头状瘤,瘤内有充满血液的腔隙,周围有部分钙化的包膜。SPT是一种罕见的惰性肿瘤。充分手术切除后预后非常好,因此术前精确诊断很重要。所以,为每位患者选择最合适的手术策略很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/029c/8614182/726acb866a83/cureus-0013-00000019880-i01.jpg

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