Ahmad Raheel, Baia Marco, Naumann David N, Mahmood Fahad, Tirotta Fabio, Ford Samuel, Desai Anant, Almond Max
Midlands Abdominal and Retroperitoneal Sarcoma Unit (MARSU), Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, Birmingham, UK.
J Surg Case Rep. 2022 Jul 25;2022(7):rjac331. doi: 10.1093/jscr/rjac331. eCollection 2022 Jul.
Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare malignancy with a low malignant potential and strong female preponderance. Diagnosis during pregnancy is extraordinary, and management must consider the risks to the mother and foetus of tumour growth and rupture. A large 35-cm SPN was identified on magnetic resonance imaging (MRI) in a 24-year-old woman at 6 weeks of gestation following presentation with an abdominal mass. Surgery was delayed to allow the foetus to reach as close to term as possible because surveillance MRIs showed incremental mass growth. Emergency c-section was undertaken at 35 weeks of gestation due to persistent tachycardia and suspected haemorrhage into the tumour. A Hb of 70 g/l post-delivery despite four units of RBCs and an albumin of 11 g/l necessitated urgent multivisceral surgery. Surgical resection is the mainstay of treatment for SPN. However, the strategy of choice during pregnancy remains undetermined, with more recent reports delaying surgery until post-partum.
胰腺实性假乳头状瘤（SPN）是一种罕见的恶性肿瘤，恶性潜能低，女性发病率高。孕期诊断极为罕见，治疗必须考虑肿瘤生长和破裂对母亲和胎儿的风险。一名24岁女性在妊娠6周时因腹部肿块就诊，磁共振成像（MRI）检查发现一个35厘米的大SPN。由于监测MRI显示肿块逐渐增大，手术被推迟，以便胎儿尽可能接近足月。妊娠35周时，因持续心动过速和怀疑肿瘤内出血，进行了急诊剖宫产。产后尽管输注了4单位红细胞，血红蛋白仍为70g/l，白蛋白为11g/l，因此需要紧急进行多脏器手术。手术切除是SPN的主要治疗方法。然而，孕期的最佳治疗策略仍未确定，最近的报告倾向于将手术推迟到产后。
