胰腺实性假乳头状瘤8例临床分析

Clinical analysis of 8 cases with solid-pseudopapillary tumor of the pancreas

目的评价胰腺实性假乳头状瘤的临床表现、诊断及治疗措施和预后。方法对我院自1980年4月至2005年7月收治的8例胰腺实性假乳头状瘤进行回顾性分析。结果8例患者年龄18—34岁，平均24．5岁，均为女性。4例因触及上腹部包块就诊，2例有腹胀症状，2例无症状。B超发现胰腺低回声实性或囊实性占位。CT发现胰腺低密度占位性病变，增强扫描肿瘤周边或实质内出现不规则强化。血清肿瘤标记物均为阴性。肿瘤位于胰头部5例，胰体尾部3例。肿瘤的平均直径为6．2cm（4—8cm）。5例行Whipple手术，3例行胰体尾切除术，术后未进行放、化疗。8例患者均获随访，平均随访时间7．25年（3—25年），均无复发或转移。结论胰腺实性假乳头状瘤是一种罕见的低度恶性肿瘤，好发于青年女性。手术切除可治愈，预后良好。

Objective To evaluate the clinical presentations of solid-pseudopapillary tumor of the pancreas （SPT） and examine the diagnosis,treatment and prognosis of SPT.Methods Eight patients with SPT managed in our hospital between April 1980 and July 2005 were reviewed. Results All the patients,female with mean age of 24.5 years （ranged from 18 to 34 years old） were diagnosed as SPT at our institution. Clinical presentation included a palpable abdominal mass in four patients and abdominal distention in another two. Two patients were asymptomatic;their tumors were found incidentally on abdominal sonographic examination for other reasons .Solid and solid-cystic masses of low echo were found in pancreas by ultrasonic examinations. CT scan found masses of low density in pancreas, while irregular enhancement appeared in the circunfference or parenchyma of all tumors in enhanced CT scan sequences. Tumor markers in patients, serum were all negative. The lesions located in the body and tail in three cases and in the head of the pancreas in five. The mean diameter of the tumors in the eight patients was 6.2 cm （ranged from 4 to 8 cm）. Pancreaticoduodenectomy were performed in 5 cases. Three patients underwent distal pancreatectomy and spleen resection. None of the patients received adjuvant therapy. The mean follow up was 7.25 years （ranged from 3 to 25 years）. No evidence of relapses and metastasis in these cases was found. Conclusion Solid-pseudopapillary tumor of pancreas is a rare tumor with low malignant potential, affecting primarily young women. Surgical resection is generally curative and the prognosis is excellent.