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弗兰茨肿瘤:胰腺实性假乳头状瘤病例报告

Frantz Tumor: A Case Report of Solid Pseudopapillary Tumor of Pancreas.

作者信息

Stefanova Nadezhda, Kalinov Turgay, Kolev Nikola, Kalchev Emilian

机构信息

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, "St. Marina" University Hospital, Varna, BGR.

Department of General Surgery, Medical University of Varna, "St. Marina" University Hospital, Varna, BGR.

出版信息

Cureus. 2023 Jul 11;15(7):e41698. doi: 10.7759/cureus.41698. eCollection 2023 Jul.

Abstract

The solid pseudopapillary tumor (SPT) is a rare pancreatic lesion that usually affects young and middle-aged patients and has a female predominance and low malignant potential. The exact histogenesis of this tumor is still unclear. We present the case of a 60-year-old female patient with occasional abdominal pain. Positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) revealed a tumor mass in the pancreatic tail. Distal pancreatectomy and splenectomy were performed. The result from the pathology report was solid pseudopapillary neoplasm (SPN). The patient underwent four cycles of adjuvant chemotherapy with gemcitabine, which she tolerated well without complaints. A control computed tomography (CT) scan and PET/CT of the abdomen (five months after the operation) showed a cystic lesion suspicious for local recurrence in the pancreatic tail during the follow-up period. The patient underwent a second surgery operation. Subsequent histological examination showed chronic indurative pancreatitis, areas with steatonecrosis, lipogranulomas, and fibrosis without evidence of relapse. SPT is a rare pancreatic tumor that most commonly affects young women. Although the tumor has locally aggressive characteristics, the prognosis is excellent after surgical excision. Our case emphasizes that this tumor can occur not only in young women but also in older patients. Chronic granulomatous inflammation and indurative pancreatitis can sometimes mimic a relapse on CT and PET/CT image tests.

摘要

实性假乳头状肿瘤(SPT)是一种罕见的胰腺病变,通常影响中青年患者,女性居多,恶性潜能低。该肿瘤的确切组织发生仍不清楚。我们报告一例60岁女性患者,偶发腹痛。正电子发射断层扫描/计算机断层扫描(PET/CT)和磁共振成像(MRI)显示胰尾有一肿瘤肿块。行胰体尾切除术和脾切除术。病理报告结果为实性假乳头状肿瘤(SPN)。患者接受了四个周期的吉西他滨辅助化疗,耐受性良好,无不适主诉。术后五个月腹部的计算机断层扫描(CT)对照检查和PET/CT显示随访期间胰尾有一个可疑局部复发的囊性病变。患者接受了二次手术。随后的组织学检查显示为慢性硬化性胰腺炎,伴有脂肪坏死、脂肪肉芽肿和纤维化区域,无复发证据。SPT是一种罕见的胰腺肿瘤,最常见于年轻女性。虽然该肿瘤具有局部侵袭性特征,但手术切除后的预后良好。我们的病例强调这种肿瘤不仅可发生于年轻女性,也可发生于老年患者。慢性肉芽肿性炎症和硬化性胰腺炎有时在CT和PET/CT图像检查中可类似复发表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a504/10413994/a683f901ae08/cureus-0015-00000041698-i01.jpg

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