Wu Guo-Zhen, Lu Li-Na, Lin Hai-Ping, Wang Xin-Yu, Yu Shi-An, Yu Min
Department of Hepatobiliary and Pancreatic Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China.
Department of Gastroenterology, Wenrong Hospital of Jinhua City, Jinhua 321000, Zhejiang Province, China.
World J Gastrointest Surg. 2025 Apr 27;17(4):105096. doi: 10.4240/wjgs.v17.i4.105096.
Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas is an extremely rare pancreatic tumor, with only sporadic cases reported in the literature. IOPN is difficult to diagnose and highly prone to misdiagnosis. IOPN carries a certain risk of progressing to invasive cancer. Surgical resection is the primary treatment for IOPN. According to the existing literature reports, the vast majority of patients with IOPN of the pancreas undergo open surgery, while only one case of laparoscopic surgery have been reported.
This report presents two cases of IOPN in elderly female patients, aged 60 and 61. Both patients were asymptomatic, and their pancreatic masses were discovered incidentally. Preoperative diagnosis of IOPN is challenging and prone to misdiagnosis. In the first case, the patient underwent a laparoscopic distal pancreatectomy and splenectomy. The surgical procedure spanned 342 minutes, with an estimated intraoperative blood loss of around 100 mL. The patient experienced an uneventful postoperative recovery and was discharged on the 8 postoperative day. For the second case, a laparoscopic pancreaticoduodenectomy was performed. The operation lasted for 431 minutes with an intraoperative blood loss of approximately 50 mL. The patient also demonstrated a favorable postoperative course and was discharged on the 24 postoperative day. Postoperative pathology and immunohistochemistry confirmed the diagnosis of IOPN. No recurrence was observed in either patient after follow-up periods of 8 and 10 months, respectively.
These cases demonstrate that laparoscopic surgery can be considered as one of the treatment options for IOPN of the pancreas.
胰腺导管内嗜酸性乳头状肿瘤（IOPN）是一种极其罕见的胰腺肿瘤，文献中仅报道过散发病例。IOPN难以诊断，极易误诊。IOPN有一定进展为浸润性癌的风险。手术切除是IOPN的主要治疗方法。根据现有文献报道，绝大多数胰腺IOPN患者接受开放手术，而腹腔镜手术仅报道过1例。
本报告介绍了2例60岁和61岁老年女性患者的IOPN病例。两名患者均无症状，胰腺肿块均为偶然发现。术前诊断IOPN具有挑战性且容易误诊。第一例患者接受了腹腔镜远端胰腺切除术和脾切除术。手术过程持续342分钟，估计术中失血量约100毫升。患者术后恢复顺利，术后第8天出院。第二例患者进行了腹腔镜胰十二指肠切除术。手术持续431分钟，术中失血量约50毫升。患者术后病程也良好，术后第24天出院。术后病理及免疫组化确诊为IOPN。分别随访8个月和10个月后，两名患者均未观察到复发。
这些病例表明，腹腔镜手术可被视为胰腺IOPN的治疗选择之一。
