Sunakawa Taiki, Kobayashi Shin, Kudo Masashi, Sugimoto Motokazu, Kobayashi Tatsushi, Gotohda Naoto
Department of Hepato-Biliary-Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
J Surg Case Rep. 2024 Jul 16;2024(7):rjae205. doi: 10.1093/jscr/rjae205. eCollection 2024 Jul.
Paragangliomas (PGLs) located around the pancreas are rare and challenging to diagnose preoperatively. Tumor resection with pancreatectomy is often performed for peripancreatic PGL. However, pancreas-sparing tumor resection can be indicated with an accurate preoperative diagnosis. Six patients with pathologically diagnosed peripancreatic PGL were included. The clinical data were retrospectively collected from medical records. Five of them were suspected of peripancreatic PGL on imaging studies due to the fat plane identified between the tumor and pancreas, and subsequently diagnosed with PGL preoperatively based on elevated urinary catecholamine levels and/or metaiodobenzylguanidine scintigraphy without biopsy. All patients underwent pancreas-sparing tumor resection with negative surgical margins, and they did not develop postoperative complications related to potential damage to the pancreas. A fat plane between the tumor and pancreas on imaging studies and hormone levels are key findings for obtaining an accurate preoperative diagnosis of peripancreatic PGL, which can be managed with pancreas-sparing tumor resection.
位于胰腺周围的副神经节瘤（PGLs）较为罕见，术前诊断具有挑战性。对于胰腺周围PGL，常采用胰腺切除术进行肿瘤切除。然而，术前准确诊断后可考虑保留胰腺的肿瘤切除术。纳入6例经病理诊断为胰腺周围PGL的患者。从病历中回顾性收集临床资料。其中5例因影像学检查发现肿瘤与胰腺之间存在脂肪平面而怀疑为胰腺周围PGL，随后在未进行活检的情况下，基于尿儿茶酚胺水平升高和/或间碘苄胍闪烁显像术前诊断为PGL。所有患者均接受了切缘阴性的保留胰腺肿瘤切除术，且未发生与胰腺潜在损伤相关的术后并发症。影像学检查中肿瘤与胰腺之间的脂肪平面以及激素水平是术前准确诊断胰腺周围PGL的关键发现，可通过保留胰腺的肿瘤切除术进行治疗。
