胰体尾混合癌自发破裂致腹腔内大出血的诊断与治疗

Diagnosis and treatment of intraperitoneal hemorrhage from spontaneous rupture of mixed pancreatic cancer

胰腺癌中导管癌占85％- 90％,其次是内分泌细胞癌,腺泡细胞癌,间叶组织来源少见,3种细胞来源混合癌则更为罕见.胰腺癌多为乏血供肿瘤,鲜有报道胰腺癌自发性破裂出血者.2014年6月哈尔滨医科大学附属第二医院收治1例胰体尾部混合性腺泡-内分泌-导管癌患者,因肿瘤自发性破裂致腹腔内大出血于当日行急诊手术治疗.随访至2015年1月20日,患者因胰腺癌腹腔内广泛种植性转移而死亡.此类患者虽极其罕见,一旦发病病情进展较快,癌细胞极易转移和扩散,患者预后差.而及时手术干预是终止病情恶化的关键,有利于拯救患者生命.

Pancreatic ductal carcinoma accounts for 85%-90% in pancreatic cancer, followed by the pancreatic cellendocrine tumors and pancreatic acinar cell carcinoma.In addition, mesenchymal cell carcinoma of pancreas is rare, and a mixed pancreatic cancer from 3 cells carcinoma is extremely rare.And pancreatic cancer always assume hypovascular tumor,spontaneous rupture of pancreatic cancer is rarely reported.A patient with a mixed duct-acinar-islet cell tumor of pancreas was admitted to the Second Affiliated Hospital of Harbin Medical University in June 2014, and underwent emergent operation of intraabdominal bleeding due to spontaneous rupture of tumor.The follow-up was done up to January 20, 2015.The patient died of intraabdominal widespread implantation metastasis of pancreatic cancer.A mixed duct-acinar-islet cell tumor of pancreas is extremely rare and easy to metastasis and diffusion of tumor with a rapid disease progression and a poor prognosis of patient,while operation is the key to terminate deterioration of the condition, and is the last line of defense to save lives.