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胰腺囊腺瘤,一种潜在的恶性肿瘤(作者译)

[Cystadenoma of the pancreas, a potentially malignant tumor (author's transl)].

作者信息

Wymer T, Rosenberger J, Féaux de Lacroix W

出版信息

Leber Magen Darm. 1981 Aug;11(4):185-8.

PMID:7300547
Abstract

Cystadenomas occur rather rarely among the cystic lesions of the pancreas, but they nevertheless require special attention. These cystadenomas do have a tendency for malignant degeneration, especially their mucinous form with papillary proliferation of the epithelium; insofar cystadenomas have to distinguished from retention nor pseudocysts, resulting from pancreatitis or from traumatic lesions of the pancreas. Differentiation of cystadenomas and other cysts can neither be achieved by preoperative diagnostic procedures nor by macroscopic findings during surgery. Diagnosis however can be established after biopsy during surgery. A cystadenoma has to be suspected especially in women of middle age, who do not have any history of pancreatitis, abdominal trauma or alcoholism, if the lesion is localized in the corpus or tail are of the pancreas. Cystadenoma have to be treated as potentially malignant tumors. The therapy of choice is excision far out in normal tissue; this is the only way to prevent relapses and to avoid transition of the lesion into a carcinoma. Thus, it has to be postulated for all patients who are being operated upon because of cysts of the pancreas that multiple biopsies should be done from various parts of the cystic wall during surgery and that drainage of the cyst should be performed only if a cystadenoma can be excluded.

摘要

胰腺囊性病变中囊腺瘤相当少见,但仍需特别关注。这些囊腺瘤确实有恶变倾向,尤其是伴有上皮乳头样增生的黏液性囊腺瘤;因此,囊腺瘤必须与潴留性囊肿或假性囊肿相鉴别,后者由胰腺炎或胰腺创伤性病变引起。术前诊断程序或手术中的宏观表现均无法实现囊腺瘤与其他囊肿的鉴别。然而,手术中活检后可确立诊断。如果病变位于胰腺体部或尾部,尤其对于没有胰腺炎、腹部创伤或酗酒史的中年女性,应怀疑为囊腺瘤。囊腺瘤必须被视为潜在的恶性肿瘤。首选的治疗方法是在正常组织中广泛切除;这是预防复发和避免病变转变为癌的唯一方法。因此,对于所有因胰腺囊肿接受手术的患者,必须假定在手术期间应从囊壁的不同部位进行多次活检,并且仅在排除囊腺瘤的情况下才进行囊肿引流。

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