Department of General Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Department of General Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
BMJ Case Rep. 2022 Mar 8;15(3):e245956. doi: 10.1136/bcr-2021-245956.
Solid pseudopapillary neoplasms (SPNs) of the pancreas (also known as Franz tumours) are rare, representing 1%-2% of pancreatic tumours. They are of exocrine gland origin and are more prevalent in women under the age of 30. They are classified as low-grade malignancies and are usually treated with surgery.We present the case of a young woman who was found to have a pancreatic head lesion obstructing the superior mesenteric vein and encasing the superior mesenteric artery. Diagnosis of SPN was confirmed on histology. Initially deemed unresectable due to vascular encasement, the patient received neoadjuvant chemotherapy to downstage the tumour. This was unsuccessful. Given the patient's young age and lack of other options, surgery was performed. Instead of vascular resection, the tumour was split and peeled off the superior mesenteric artery giving an R1 resection. The patient has achieved long-term recurrence free survival at 10 years.
胰腺实性假乳头状瘤（SPN，也称为 Franz 肿瘤）较为罕见，占胰腺肿瘤的 1%-2%。它们来源于外分泌腺，多见于 30 岁以下的女性。这些肿瘤被归类为低度恶性肿瘤，通常采用手术治疗。我们报告了一例年轻女性患者，她被发现胰腺头部有一个病变，该病变阻塞了肠系膜上静脉并包裹了肠系膜上动脉。组织学检查证实为 SPN。由于血管包裹，最初认为该病变不可切除，患者接受了新辅助化疗以降期肿瘤。但该方案无效。鉴于患者年龄较轻且别无选择，我们对其进行了手术治疗。我们没有进行血管切除，而是将肿瘤切开并从肠系膜上动脉上剥离，实现了 R1 切除。患者术后 10 年无复发生存。
