外科治疗胰腺实性假乳头状瘤4例报告

The report of four cases of the solid-pseudopapillary tumor of the pancreas treated by surgery

目的:探讨胰腺实性假乳头状瘤的临床表现、诊断、外科治疗及预后。方法:收集我院2011年1月至2012年10月间4例胰腺实性假乳头状瘤患者的临床资料,就其临床表现、诊疗措施以及随访预后进行回顾性分析总结。结果:4例患者平均年龄为28.8岁;3例为女性,1例为男性;3例为体检时无意间发现,1例有腹痛症状;术前影像学检查均发现胰腺囊实性肿块,各项肿瘤标记物血清学检测指标无明显特异性。肿瘤位于胰头1例,胰体尾部3例,4例均接受了胰腺部分切除,1例实施了保留十二指肠胰头,3例实施了胰体尾切除术,其中1例实施了脾脏切除手术,术后均未进行放、化疗治疗。4例术后随访6～22月,患者均存活,未发现肿瘤转移或复发。结论:胰腺实性假乳头状瘤是一种好发于青年女性的胰腺低度恶性肿瘤,预后良好,通过适当的外科治疗可以治愈。

Objective： To evaluate the clinical presentations, diagnosis, surgical treatment and prognosis of the solid- pseudopapillary tumor of the pancreas （SPT）. Method： Four cases with SPT were collected in our hospital from January 2011 to October 2012, and their clinical manifestation, diagnosis methods, and the follow-up prognosis were reviewed. Result： The age of four patients were 22-36 years old, whose mean age was 28.8 years. Among them, three were female, and one male. Three cases were diagnosed as SPT inadvertently in our institution physical examination and one had abdominal pain symptom. The preoperative imaging examination all found solid pseudopapillary tumour of pancreas and serological examination of various tumor markers had no obvious specificity. The one tumor located in the head and other three in tale. Four cases all had received partial pancreatectomy, among which one patient preserved duodenum and pancreatic head, three underwent distal pancreatectomy, one of which had spleen resection. None of the patients received radiotherapy and chemotherapy. The follow- up of four cases ranged from 6 to 22 months. All patients survived and no evidence of relapses and metastasis were found. Conclusion： The solid-pseudopapillary tumor of pancreas is predilection in young women which is a low grade malignant pancreatic tumor and its prognosis is excellent. The appropriate surgical therapy can cure it.