Shrager J B, Greelish J, Van Arsdale C, Furth E, Daly J M
Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia.
Surg Oncol. 1994 Aug;3(4):203-10. doi: 10.1016/0960-7404(94)90035-3.
We describe the case of a 78 year old woman with a severely dysplastic villous adenoma of the duct of Wirsung presenting with abdominal pain, emesis, weight loss, and hyperamylasemia. Abdominal ultrasound, computed tomography, and endoscopic retrograde cholangiopancreatography suggested an intraductal lesion in the head of the pancreas with a dilated distal duct. The patient underwent uncomplicated pancreaticoduodenectomy and has done well. A review of the literature on benign and malignant neoplasms of the main pancreatic duct allows formulation of the typical clinical syndrome, appropriate diagnostic work-up, treatment, and prognosis of patients with these rare lesions. The pancreatic ductal epithelium can present the full spectrum of lesions along the pathogenetic route to malignancy. This is evidence for the presence of an adenoma-to-carcinoma sequence in the pancreas analogous to that which exists in the colon.
我们描述了一名78岁女性的病例，该患者患有严重发育异常的胰管绒毛状腺瘤，表现为腹痛、呕吐、体重减轻和高淀粉酶血症。腹部超声、计算机断层扫描和内镜逆行胰胆管造影显示胰腺头部有导管内病变，远端导管扩张。患者接受了无并发症的胰十二指肠切除术，术后恢复良好。对主胰管良恶性肿瘤的文献回顾有助于制定这些罕见病变患者的典型临床综合征、适当的诊断检查、治疗和预后。胰腺导管上皮在恶变的发病过程中可呈现出完整的病变谱。这证明胰腺中存在腺瘤到癌的序列，类似于结肠中存在的序列。
