Saint-Marseille S, Lapointe R, Roy A, Dagenais M, Gagnon J, Lavoie P
Département de Chirurgie, Hôpital Saint-Luc, Montréal, Québec, Canada.
Ann Chir. 1994;48(8):697-702.
Cystadenomas and cystadenocarcinomas are rare cystic tumors of pancreas. Clinicopathological features and treatment of these neoplasms have been studied in 36 patients over a 10-year period (1983-1993). There were 19 cystadenomas (CA) either serous (n = 13) or mucinous (n = 6) and 17 cystadenocarcinomas (CAC). Eighteen CA (95%) were found in women. CAC were found equally between both sexes. Median age was 63 years and was the same for CA and CAC. Ultrasound gave correct diagnosis of CA or CAC in 64% and CT-scan in 77%. The majority of CAC (n = 15) were localized in the head of the pancreas. CA had no preferential localization. 24 patients (66%) underwent including resection (n = 20) and biopsy (n = 4). Four other patients had a percutaneous biopsy and 8 were observed. Hospital mortality was 8%. Complications included gastric atony (n = 4) and pancreatic fistula (n = 2). Four-year actuarial survival is 63% for resected CAC and 100% for resected CA. In conclusion, most cystic pancreatic tumors are found in women. Malignant lesions are found predominately in the head of the pancreas. Modern imaging technics combined with clinical presentation are reliable in obtaining a diagnosis. Resection remains the treatment of choice.
囊腺瘤和囊腺癌是胰腺罕见的囊性肿瘤。在10年期间（1983 - 1993年）对36例患者的这些肿瘤的临床病理特征及治疗情况进行了研究。其中有19例囊腺瘤（CA），包括浆液性（n = 13）和黏液性（n = 6），以及17例囊腺癌（CAC）。18例囊腺瘤（95%）见于女性。囊腺癌在男女中发现比例相同。中位年龄为63岁，囊腺瘤和囊腺癌相同。超声对囊腺瘤或囊腺癌的正确诊断率为64%，CT扫描为77%。大多数囊腺癌（n = 15）位于胰头。囊腺瘤无特定好发部位。24例患者（66%）接受了包括切除（n = 20）和活检（n = 4）。另外4例患者进行了经皮活检，8例进行了观察。医院死亡率为8%。并发症包括胃无力（n = 4）和胰瘘（n = 2）。切除的囊腺癌4年精算生存率为63%，切除的囊腺瘤为100%。总之，大多数胰腺囊性肿瘤见于女性。恶性病变主要位于胰头。现代影像学技术结合临床表现对诊断很可靠。手术切除仍是首选治疗方法。
