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胰体尾切除术:实性假乳头状肿瘤的一种可行选择——病例报告

Central pancreatectomy: A viable option for solid pseudopapillary neoplasm - A case report.

作者信息

Ijaz Aarzish, Zahid Muhammad Jawad, Ullah Mahnoor Ata, Hussain Musarrat

机构信息

Resident General Surgery, Hayatabad Medical Complex, Phase 4, Hayatabad, Peshawar, 25000, Pakistan.

Resident General Surgery, Hayatabad Medical Complex, Phase 4, Hayatabad, Peshawar, 25000, Pakistan.

出版信息

Int J Surg Case Rep. 2023 Sep;110:108754. doi: 10.1016/j.ijscr.2023.108754. Epub 2023 Sep 1.

Abstract

INTRODUCTION

Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare tumors, comprising about 1 % of pancreatic tumors. They primarily affect females during their reproductive phase and have a favorable prognosis. SPNs are usually asymptomatic or present with mild symptoms. The exact histopathogenesis of SPNs remains unknown. Surgical resection is curative, and central pancreatectomy is a pancreas-sparing surgical technique.

CASE PRESENTATION

A 33-year-old female presented with epigastric pain, vomiting, and infertility. Imaging revealed a mass in the pancreas. Exploration confirmed the mass, and central pancreatectomy was performed. Histopathology confirmed the diagnosis of SPN. The patient's recovery was uneventful, and follow-up CT scans showed no recurrence.

DISCUSSION

This case involves a 33-year-old female presenting with epigastric pain and vomiting, revealing a cystic mass with a solid component in the pancreas. While generally benign, SPNs can become malignant in 15 % cases, with a favorable prognosis. Histopathologically, SPNs remain distinct, with CD99 and CD10 staining confirming the diagnosis. Diagnostic imaging, particularly CT scans, aids in identifying SPNs. Surgical resection, such as central pancreatectomy, is effective, preserving organ function. The case's positive outcome aligns with an overall 5-year survival rate of 95-97 %, highlighting the overall favorable prognosis of SPNs. The procedure's balance between tumor removal and organ preservation offers clinical advantages.

CONCLUSION

This case underscores the successful management of an SPN using central pancreatectomy. It highlights the importance of early diagnosis and surgical intervention, as well as the favorable prognosis associated with SPNs, even in cases of metastasis. Central pancreatectomy offers organ preservation and reduces long-term complications. Continued reporting and research on such cases contribute to refining treatment strategies for SPNs.

摘要

引言

胰腺实性假乳头状肿瘤(SPN)是罕见肿瘤,约占胰腺肿瘤的1%。它们主要影响处于生育期的女性,预后良好。SPN通常无症状或仅有轻微症状。SPN的确切组织发病机制尚不清楚。手术切除可治愈疾病,而胰体尾切除术是一种保留胰腺的手术技术。

病例介绍

一名33岁女性出现上腹部疼痛、呕吐和不孕。影像学检查显示胰腺有肿块。探查证实有肿块,遂行胰体尾切除术。组织病理学确诊为SPN。患者恢复顺利,后续CT扫描未显示复发。

讨论

本病例为一名33岁女性,表现为上腹部疼痛和呕吐,影像学检查显示胰腺有一个含有实性成分的囊性肿块。虽然SPN通常为良性,但在15%的病例中可能会恶变,不过预后良好。在组织病理学上,SPN具有独特性,CD99和CD10染色可确诊。诊断性影像学检查,尤其是CT扫描,有助于识别SPN。手术切除,如胰体尾切除术,是有效的,可保留器官功能。该病例的良好结局与整体95% - 97%的5年生存率相符,突出了SPN总体良好的预后。该手术在肿瘤切除和器官保留之间取得的平衡具有临床优势。

结论

本病例强调了使用胰体尾切除术成功治疗SPN。它突出了早期诊断和手术干预的重要性,以及即使在发生转移的情况下SPN仍具有良好预后。胰体尾切除术可保留器官并减少长期并发症。持续报告和研究此类病例有助于完善SPN的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d58a/10509922/21d2216e860b/gr1.jpg

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