胰腺实性假乳头状瘤8例临床报道

Solid-pseudopapillary Tumor of the Pancreas:8 Cases Report

目的评价胰腺实性假乳头状瘤（SPT）的临床表现、诊断及治疗措施和预后.方法对宣武医院自1980年4月至2005年7月收治的8例胰腺实性假乳头状瘤病例进行回顾性分析.结果 8例平均年龄为24.5岁的女性患者中,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.血清肿瘤标志物均为阴性.肿瘤位于胰头5例,胰体尾部3例.肿瘤的平均直径为6.2cm（4～8 cm）.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 manifestations of solid-pseudopapillary tumor of the pancreas （SPT） and examine the diagnosis, treatment and prognosis of this rare disease. Methods We retrospectively reviewed a series of eight patients with SPT admitted in our hospital from April 1980 to July 2005. Results All the patients are female with mean age of 24.5 years （range 18 to 34 years） were diagnosed with 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 in ultrasonic examinations. CT scan found masses of Low density in pancreas, while irregular enhancement appeared in the circumference or parenchyma of all tumors in enhanced CT scan sequences. Tumor markers in patients＇ serum were all negative. The lesions were 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 （range 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 （range 3 to 25 years）. No evidence of relapses and metastasis in these cases was found. Conclusion Solidpseudopapillary 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.