Lee W J, Park Y T, Choi J S, Chi H S, Kim B R
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 1996 Apr;37(2):131-41. doi: 10.3349/ymj.1996.37.2.131.
Solid and papillary neoplasms of the pancreas, a rare tumor usually found in young female patients, seldom presents with metastasis since it is a tumor with low potential for malignancy. The prognosis for this lesion is much more favorable than that for other pancreatic neoplasms. In an attempt to understand the characteristics and prognosis of this lesion, we reviewed twenty cases treated at the Department of Surgery, Severance Hospital, Yonsei University from 1985 to 1994. The mean age of the patients was 25.6 years (range: 13 to 39 years), and 19 (95%) were women. Chief complaints were palpable mass (50%), pain (45%), and indigestion (5%). In laboratory studies, tumor markers, including CEA, CA125, CA19-9, and aFP were studied in eight patients, and found negative. Other laboratory findings were also nonspecific. These tumors may occur anywhere in the pancreas. In our studies, the tumor was most often located in the tail (45%), and the head (40%) of the pancreas. These were treated by distal pancreatectomy and splenectomy (55%), Whipple's operation (20%), pylorus preserving pancreatoduodenectomy (10%), enucleation (10%) or excision (5%). Significant morbidity or mortality was not observed during hospitalization, and no recurrence or malignant degeneration occurred during the mean follow-up period of 4 years (range: 1 month to 9 years). In conclusion, this study has suggested that the patients with a solid and papillary neoplasm of the pancreas have a good prognosis for successful treatment, if the disease is diagnosed early and the tumor is completely resected. A higher index of suspicion, and more aggressive diagnostic workups are needed in dealing with this disease entity.
胰腺实性假乳头状肿瘤是一种罕见肿瘤，多见于年轻女性患者，因其恶性潜能较低，很少发生转移。该病变的预后比其他胰腺肿瘤要好得多。为了解该病变的特征和预后，我们回顾了1985年至1994年在延世大学Severance医院外科治疗的20例病例。患者的平均年龄为25.6岁（范围：13至39岁），其中19例（95%）为女性。主要症状为可触及肿块（50%）、疼痛（45%）和消化不良（5%）。在实验室检查中，对8例患者进行了包括癌胚抗原（CEA）、糖类抗原125（CA125）、糖类抗原19-9（CA19-9）和甲胎蛋白（aFP）在内的肿瘤标志物检测，结果均为阴性。其他实验室检查结果也无特异性。这些肿瘤可发生于胰腺的任何部位。在我们的研究中，肿瘤最常位于胰尾（45%）和胰头（40%）。治疗方法包括胰体尾切除术加脾切除术（55%）、惠普尔手术（20%）、保留幽门的胰十二指肠切除术（10%）、肿瘤剜除术（10%）或切除术（5%）。住院期间未观察到严重的发病率或死亡率，在平均4年（范围：1个月至9年）的随访期内未发生复发或恶性变。总之，本研究表明，胰腺实性假乳头状肿瘤患者若能早期诊断并完整切除肿瘤，其治疗预后良好。对于这种疾病实体，需要提高怀疑指数并进行更积极的诊断检查。
