10例胰腺导管腺癌卵巢转移瘤的临床病理特征和预后

Ovarian metastases of pancreatic ductal adenocarcinomas:the clinicopathological characteristics and outcomes of 10 cases

目的:探讨胰腺导管腺癌卵巢转移瘤患者的临床病理特征和预后。方法:回顾性分析1984—2018年就诊于北京协和医院经组织病理学证实的10例胰腺导管腺癌卵巢转移瘤患者的临床病理特征、治疗及随访情况。结果:10例患者的中位发病年龄为46岁,其中8例原发肿瘤位于胰腺体尾部。8例患者诊断时即有双侧卵巢转移,从有临床症状至发现卵巢转移的中位时间为2.5个月。全组患者均有腹膜转移,9例患者伴血CA125升高。转移瘤以囊实性外观多见(8例次),病理形态多表现为黏液腺癌(6例),免疫组化无明显特征。全组患者均于发病时行卵巢姑息切除手术,1例患者同时行原发灶切除术。7例患者行化疗。10例患者的中位生存时间为10.3个月。结论:胰腺导管腺癌卵巢转移瘤容易误诊,诊断需要结合临床表现、影像学检查和病理特征,手术可能改善患者的预后。

Objective To investigate the clinicopathological characteristics and outcomes of a series of ovarian metastases of pancreatic ductal adenocarcinoma.Methods Data of clinical manifestation,pathological characteristic,treatment and follow-up result from ten patients with ovarian metastases of pancreatic ductal adenocarcinoma confirmed by pathology were retrospectively analyzed.Results The median age of onset was 46 years(38~79 years).The primary tumors were located in the body and tail of the pancreas in 8 cases.Bilateral ovarian metastasis occurred in 8 patients at the time of diagnosis.The median time from patients with clinical symptom to ovarian metastases was 2.5 months(0~12 months).Peritoneal metastasis was found in all of 10 cases.Nine cases were accompanied by CA125 elevation.The major features of metastatic carcinoma in the ovary were cystic-solid appearance(8 cases)and mucinous adenocarcinoma(6 cases)with no obvious immunohistochemical features in pathological observation.All patients underwent palliative ovariectomy at onset,and one patient underwent primary tumor resection simultaneously.Seven patients received chemotherapy.The median survival time of the 10 patients was 10.3 months.Conclusions Ovarian metastases of pancreatic ductal adenocarcinoma are easily misdiagnosed.The final diagnosis depends on clinical manifestations,imaging and histopathological observation.Ovariectomy may be associated with better outcome.