Paramythiotis Daniel, Karlafti Eleni, Tsavdaris Dimitrios, Mekras Alexandros, Ioannidis Aristeidis, Panidis Stavros, Psoma Elizabeth, Prassopoulos Panos, Michalopoulos Antonios
First Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Emergency Department, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
J Pers Med. 2025 May 28;15(6):221. doi: 10.3390/jpm15060221.
Pancreatic ductal adenocarcinoma (PDAC) is the most common pancreatic malignancy and is characterized by a very unfavorable prognosis. Rarely, patients may develop synchronous PDAC and another distinct primary pancreatic tumor, such as a pancreatic neuroendocrine tumor. This systematic review consolidates published case reports describing the presentation, imaging characteristics, management, and outcomes of patients with synchronous PDAC and other pancreatic malignancies. : A comprehensive search of PubMed and Scopus identified 26 relevant case reports, with inclusion criteria focused on histologically confirmed synchronous pancreatic tumors and exclusion of metastatic disease. : The majority of patients present with two pancreatic lesions, often located in both the body and tail of the pancreas. Diagnostic imaging modalities, such as computed tomography and endoscopic ultrasound, reveal common findings. Tumor markers, particularly CA 19-9, are often elevated and aid in the diagnosis. Surgical approaches also vary according to tumor location and staging, with procedures ranging from Whipple surgery to total pancreatectomy. Chemotherapy is frequently employed postoperatively. Notably, lymph node involvement and larger tumor size are associated with poorer prognoses. : In conclusion, these patients may present with a common or non-common clinical picture as well as laboratory and imaging findings, constituting an important and unique diagnostic and therapeutic challenge.
胰腺导管腺癌（PDAC）是最常见的胰腺恶性肿瘤，其特征是预后非常差。很少有患者会同时发生PDAC和另一种不同的原发性胰腺肿瘤，如胰腺神经内分泌肿瘤。本系统综述汇总了已发表的病例报告，描述了同时患有PDAC和其他胰腺恶性肿瘤患者的临床表现、影像学特征、治疗及预后。：对PubMed和Scopus进行全面检索，确定了26篇相关病例报告，纳入标准侧重于组织学确诊的同时性胰腺肿瘤，并排除转移性疾病。：大多数患者有两个胰腺病变，通常位于胰腺体部和尾部。诊断性成像检查方法，如计算机断层扫描和内镜超声，显示出常见的表现。肿瘤标志物，特别是CA 19-9，通常会升高并有助于诊断。手术方式也根据肿瘤位置和分期而有所不同，手术范围从惠普尔手术到全胰切除术。术后经常采用化疗。值得注意的是，淋巴结受累和肿瘤体积较大与预后较差有关。：总之，这些患者可能表现出常见或不常见的临床症状以及实验室和影像学检查结果，构成了一个重要且独特的诊断和治疗挑战。
