Kojima Y, Akiyama T, Saito H, Kosaka T, Kita I, Takashima S, Kinami Y, Konishi F, Matsunou H
Second Department of Surgery, Kanazawa Medical University, Ishikawa, Japan.
Surg Today. 1993;23(5):471-5. doi: 10.1007/BF00309511.
This paper describes a case of a mucin-producing tumor of the pancreas, histologically diagnosed as multifocal intraductal papillary adenocarcinoma. The patient had a markedly dilated main pancreatic duct, detected by ultrasound (US) and computed tomography (CT), and endoscopy showed a papillary tumor projecting from the patulous orifice of the enlarged papilla of Vater. Several biopsies taken from the tumor indicated a diagnosis of papillary adenocarcinoma. Total pancreatectomy was thus performed, revealing a multifocal papillary tumor growing along the main duct in the head, body, and tail of the pancreas. Microscopically, these multiple tumors were found to be mucin-producing papillary adenocarcinoma of the main and subsidiary pancreatic ducts with nodular and microfocal periductal invasion. The surgical treatment of multifocal tumors, may therefore necessitate total pancreatectomy to achieve curative resection, in some cases.
本文描述了一例胰腺黏液生成肿瘤，组织学诊断为多灶性导管内乳头状腺癌。患者的主胰管明显扩张，经超声（US）和计算机断层扫描（CT）检测到，内镜检查显示有一个乳头状肿瘤从扩大的 Vater 乳头的开放孔口突出。从肿瘤上取的几次活检表明诊断为乳头状腺癌。因此进行了全胰切除术，发现胰腺头部、体部和尾部沿主胰管有一个多灶性乳头状肿瘤生长。显微镜下，这些多个肿瘤被发现是主胰管和副胰管的黏液生成乳头状腺癌，伴有结节状和微灶性导管周围浸润。因此，在某些情况下，多灶性肿瘤的手术治疗可能需要进行全胰切除术以实现根治性切除。
