大网膜胰腺实性-假乳头瘤1例报告及文献复习

Solid pseudopapillary neoplasm of pancreas arising from majus omentum:A case report and literature review

目的:探讨1例发生在大网膜的胰腺实性-假乳头瘤(SPN)患者的病理诊断要点及鉴别诊断,提高对发生于胰腺外SPN的认识。方法:1例女性患者,因腹部包块20d入院,妇科彩超诊断为多发性子宫肌瘤,腹部超声未见明显异常,行子宫次全切术,术中发现大网膜有1个界清肿物,术中行子宫及网膜肿物切除术。结果:该患者术后病理检查诊断为多发性子宫肌瘤,肿瘤诊断为胰腺SPN,周围未见异位胰腺组织,超声及CT检查排除胰腺SPN转移,根据其形态表现及免疫组织化学特征诊断为大网膜SPN。术后随访3年,未见复发及转移。结论:发生于大网膜的SPN临床罕见,肿瘤一般界限清楚,具有典型的形态表现及免疫组织化学特点。

Objective：To explore the pathological diagnosis features and differential diagnosis of one case of patient with solid pseudopapillary neoplasm（SPN）of pancreas occurred in the majus omentum,and to improve the understanding of extra-pancreatic SPN.Methods：One female patient was admitted to hospital because of abdominal mass found 20 dago.The patient was diagnosed as multiple hysteromyoma by gynecological color ultrasound,and the results of abdominal ultrasound had no obvious abnormity.The patient underwent hysterotomy,and a welldefined mass in the majus omentum was found during operation,so the patient received hysterectomy and omental tumor resection.Results：The patient was confirmed as multiple hysteromyoma by the postoperative pathological examination.The patient was clearly diagnosed as SPN arising from the majus omentum on the basis of pathological characteristics and immunohistochemical staining results.There were no ectopic pancreas tissue arround the tumor and no SNP metastasis in examination of ultrasound and CT.No recurrence and metastasis were found in the follow-up of 3 years.Conclusion：SPN arising from the majus omentum is extremely rare.The tumor has clear boundary,typical morphology and immunohistochemical appearances.