Department of Surgery, Isesaki Municipal Hospital, Japan.
Department of Pathology, Japanese Red Cross Kyoto Daini Hospital, Japan.
Intern Med. 2023 Oct 1;62(19):2847-2853. doi: 10.2169/internalmedicine.1135-22. Epub 2023 Feb 15.
A 74-year-old woman was referred to our hospital for the evaluation of slightly elevated tumor marker levels. Computed tomography revealed a well-demarcated tumor, approximately 15 mm in diameter, in the pancreatic tail. Endoscopic ultrasound-guided fine-needle aspiration findings suggested poorly differentiated cancer. The tumor was surgically resected, but postoperative pathologic confirmation was not possible. After one year without treatment and no recurrence, an evaluation by a specialized facility was requested for a definitive diagnosis. Adenomatoid tumor was deemed most likely based on the histopathology and immunostaining findings; however, a definitive diagnosis was difficult because of atypical findings. The patient was recurrence-free for 36 months at the last follow-up.
一位 74 岁女性因肿瘤标志物轻度升高被转至我院进行评估。计算机断层扫描显示胰尾有一个边界清楚的肿瘤,直径约 15 毫米。内镜超声引导下细针抽吸的结果提示为低分化癌。肿瘤被手术切除,但术后无法进行病理确认。一年无治疗且无复发后,要求专门机构进行评估以明确诊断。根据组织病理学和免疫组化结果,认为最可能是腺肌瘤;但是由于不典型表现,明确诊断较为困难。在最后一次随访时,患者无复发且已 36 个月。