胰腺实性假乳头状瘤27例临床诊疗分析

周海洋; 吴剑挥; 郝纯毅

胰腺实性假乳头状瘤27例临床诊疗分析

北京大学肿瘤医院肝胆胰肿瘤外科

详细信息

中图分类号: R735.9
计量
- 文章访问数: 3880
- HTML全文浏览量: 16
- PDF下载量: 785
- 被引次数: 0
出版历程
- 出版日期: 2013-01-20

Solid pseudopapillary tumors of the pancreas: 27 cases from a single institution

摘要

摘要:
目的探讨胰腺实性假乳头状瘤（SPT）的临床病理特点、影像学特点,总结诊疗经验。方法对2008年9月至2012年9月我院单中心收治的27例SPT患者的临床资料进行回顾性分析。结果全部27例患者行手术切除,行胰十二指肠切除4例,保留十二指肠胰头肿瘤切除6例,胰腺中段切除5例,保留脾脏胰体尾切除5例,胰体尾+脾切除7例。27例患者中有12例合并不同程度的胰漏及发热,其中有1例术后出现脾动脉出血。全部患者随访中有1例术后2年出现复发并再次手术切除,余均未出现复发及转移,无死亡。结论胰腺SPT常见于青年女性,为交界性恶性潜能肿瘤,预后好。CT及MRI是最主要的影像学检查方法。治疗原则建议行根治性手术切除,同时争取保留周边脏器结构功能完整。
- 胰腺肿瘤 /
- 乳头状瘤 /
- 胰十二指肠切除术
Abstract:
Objective To summarize the clinicopathologic features and treatment outcomes of solid pseudopapillary tumors (SPTs) of the pancreas.Methods Twenty-seven cases of SPT of the pancreas admitted for treatment to the Peking University Cancer Hospital between September 2008 and September 2012 were retrospectively analyzed.Results The majority of the pancreatic SPT patients were young adults (median age: 29 years old) and females (85.2%) .All 27 patients were treated with surgical resection using pancreaticoduodenectomy (n=4) , duodenum preserving pancreatic tumor resection (n=6) , middle pancreatectomy (n=5) , distal pancreatectomy (n=5) , or distal pancreatectomy plus splenectomy (n=7) .The minimum tumor diameter was 1.5 cm, the maximum diameter was 12.0 cm, and the average diameter was 5.4 cm.Twelve patients developed pancreatic leakage and pyrexia following the operation.One patient suffered splenic artery hemorrhage.All 27 patients survived and completed follow-up.Only one patient developed recurrence, which was treated by a second surgical resection, and all other patients showed no clinical signs of recurrence or metastasis.Conclusion SPT of the pancreas has uncertain malignant potential with good prognosis.Radical resection with preservation of the surrounding tissues is an effective and safe treatment for SPT.
- pancreatic neoplasms /
- papilloma /
- pancreaticoduodenectomy

HTML全文

参考文献(16)

[1]Lam KY, Lo CY, Fan ST.Pancreatic solid-cystic-papillarytumor:clinicopathologic features in eight patients from HongKong and review of the literature[J].World J Surg, 1999, 23 (10) :1045-1050.

[2]Mao C, Guvendi M, Domenico DR, et al.Papillary cystic andsolid tumors of the pancreas:a pancreatic embryonic tumorStudies of three cases and cumulative review of the world's lit-erature[J].Surgery, 1995, 118 (5) :821-828.

[3]Kneeland FV.Atlas of Tumor Pathology Section 7, fascicles 27and 28[M].Washington D.C.:Armed Forces Institute of Pa-thology, 1959:32-33.

[4]Adams AL, Siegal GP, Jhala NC.Solid pseudopapillary tumorof the pancreas:a review of salient clinical and pathologicfeatures[J].Adv Anat Pathol, 2008, 15 (1) :39-45.

[5]Burford H, Baloch Z, Liu X, et al.E-cadherin/β-cateninand CD10:a limited immunohistochemical panel to distin-guish pancreatic endocrine neoplasm from solid pseudopapil-lary neoplasm of the pancreas on endoscopic ultrasound-guided fine-needle aspirates of the pancreas[J].Am J ClinPathol, 2009, 132 (6) :831-839.

[6]Kim MJ, Jang SJ, Yu E.Loss of E-cadherin and cytoplasmic-nuclear expression ofβ-catenin are the most useful immuno-profiles in the diagnosis of solid-pseudopapillary neoplasm ofthe pancreas[J].Hum Pathol, 2008, 39 (2) :251-258.

[7]Bosman FT, Carneiro F, Hruban RH, et al.Cancer TIAFRO.WHO Classification of Tumours of the Digestive System (IARC WHO Classification of Tumours) [M].4th ed.Lyon:World Health Organization, 2010:246-248.

[8]Hao CY, Lu AP, Xing BC, et al.Solid pseudopapillary tumor of thepancreas:report of 8 cases in a single institution and review of theChinese literature[J].Pancreatol, 2006, 6 (4) :291-296.

[9]Palmucci S, Uccello A, Leone G, et al.Rare pancreatic neo-plasm:MDCT and MRI features of a typical solid pseudopap-illary tumor[J].J Radiol Case Rep, 2012, 6 (1) :17-24.

[10]Choi JY, Kim MJ, Kim JH, et al.Solid pseudopapillary tumorof the pancreas:typical and atypical manifestations[J].AJRAm J Roentgenol, 2006, 187 (2) :W178-186.

[11]Nakagohri T, Kinoshita T, Konishi M, et al.Surgical outcomeof solid pseudopapillary tumor of the pancreas[J].J Hepato-biliary Pancreat Surg, 2008, 15 (3) :318-321.

[12]Yu PF, Hu ZH, Wang XB, et al.Solid pseudopapillary tumorof the pancreas:a review of 553 cases in Chinese literature[J].WJG, 2010, 16 (10) :1209-1214.

[13]Reddy S, Cameron JL, Scudiere J, et al.Surgical manage-ment of solid-pseudopapillary neoplasms of the pancreas (Franz or Hamoudi Tumors) :a large single-institutional se-ries[J].ACS, 2009, 208 (5) :950-957.

[14]Fried P, Cooper J, Balthazar E, et al.A role for radiotherapyin the treatment of solid and papillary neoplasms of the pan-creas[J].Cancer, 1985, 56 (12) :2783-2785.

[15]Maffuz A, de ThéBustamante F, Silva JA, et al.Preoperativegemcitabine for unresectable, solid pseudopapillary tumour ofthe pancreas[J].Lancet Oncol, 2005, 6 (3) :185-186.

[16]Kanter J, Wilson DB, Strasberg S.Downsizing to resectabiltyof a large solid and cystic papillary tumor of the pancreas bysingle-agent chemotherapy[J].J Pediatr Surg, 2009, 44 (10) :e23-e25.

施引文献

资源附件(0)

访问统计