十二指肠乳头神经内分泌瘤3例报告

Neuroendocrine tumor of duodenal papilla: a clinical analysis of 3 cases

目的探讨十二指肠乳头神经内分泌瘤的临床病理学特征、诊断及治疗方法。方法回顾性分析3例十二指肠乳头神经内分泌瘤患者的临床资料,男性2例,女性1例,发病年龄68、66和52岁;主要临床表现分别为上腹痛,腹泻及消化道出血;行影像学检查提示2例十二指肠降部占位,3例胃十二指肠镜检示十二指肠乳头病变,活检病理为神经内分泌瘤。3例均行胰十二指肠切除术(PD术),分析患者术后临床病理特征及预后。结果术后病理发现2例为十二指肠乳头神经内分泌肿瘤G1级,1例为G2级。3例患者均得到随访,1例术后7个月仍无瘤生存,1例术后生存>5年,1例术后4年8个月死于复发。结论十二指肠乳头神经内分泌瘤临床较罕见,无特异性临床表现,术前十二指肠镜检有助于明确诊断,积极的手术治疗是主要的治疗方式。

Objective To study the clinicopathological features, diagnosis and surgical treatment of duodenal papilla neu-roendocrine tumors （ DPNETs） .Methods Clinical data of 3 DPNET patients and their surgical treatment outcome were ret-rospectively analyzed with related literatures reviewed.The patients were 68,66 and 52 years old.Main clinical symptoms included abdominal pain, diarrhea and upper gastrointestinal bleeding.Imaging studies of 2 cases revealed mass lesions in the descending part of duodenum.Esophagogastroduodenoscopy （ EGD） of the 3 cases indicated duodenal papilla lesions. Biopsies demonstrated neuroendocrine tumors by pathology. Results All patients underwent pancreaticoduodenectomy （ PD） .Pathological reports were G1 grade in 2 cases and G2 grade in 1 case.The patients were followed up after opera-tion.Of the 3 patients, two patients survived while the other patient died due to recurrence after 4 years and 8 months of surgery.Conclusion Duodenal papilla neuroendocrine tumor is relatively rare and does not have specific clinical manifesta-tions.Preoperative EGD is helpful for diagnosis.Surgical resection is the mainstay of treatment.