胰腺实性假乳头状瘤25例临床分析

Twenty-five cases of solid pseudopaillary neoplasm of the pancreas: with clinic analysis

目的 探讨胰腺实性假乳头状瘤的临床表现,诊断及治疗经验.方法 对我院2008年9月至2013年7月收治的25例胰腺实性假乳头状瘤进行回顾性分析.结果 25例患者年龄17 ～ 54岁,平均29岁,其中女18例,男7例.11例因上腹部胀痛或腰背部酸痛等症状就诊,14例体检发现胰腺占位就诊.B超示低回声囊实性或实性占位.CT或MRI示胰腺低密度占位病变,增强CT显示强化不均,实性部分稍强化.实验室检查未见明显异常.6例行胰腺局部切除术,3例行胰十二指肠切除术,7例行胰体尾切除术,9例行胰体尾联合脾切除术.均进行随访,平均随访时间为52.2个月,均未发现肿瘤复发转移.结论 胰腺实性假乳头状瘤是一种罕见的低度恶性肿瘤,确诊依赖于病理学诊断,手术治疗是其主要治疗方式,切除肿瘤后能获得良好的预后.

Objective To discuss the clinical manifestation,diagnosis and treatment experience with solidpseudopaillary tumors of the pancreas （SPPT）. Methods Clinical data of 25 cases which were suffered from SPN from Sep. 2008 to Jul. 2013 in our hospital were retrospectively analyzed. Results There were 7 male and 18 female patients, age from 17 to 54 years, the average age was 29 years. Eleven cases were epigastria or back pain, and 14 cases had pancreas occupied diagnosed by physical examination. Ultrasound showed low echo and cystic- solid occupied, CT or MR showed low density. Enhancement CT showed uneven enhanced, solid part slightly enhanced. Laboratory tests had no abnormality. Of the 25 patients, there were 6 cases undergone local resection of pancreatic tumor, and there were 3 cases undergone pancreaticoduodenectomy, and there were 7 cases under- gone distal pancreatectomy, and there were 9 cases undergone distal pancreatectomy, including 5 cases with splenectomy. All patients had been followed up. The mean follow-up time was 52.2 months. All patients had not recurrence and metastasis. Conclusion SPTP was a rare low-grade malignant tumor, and the correct diagno- sis dependent on histopathology examination, and operation was the main treatment method. It had a good prognosis after resection of the tumor.