原发性胰腺副神经节瘤诊治分析

目的为原发性胰腺副神经节瘤的临床诊疗提供参考.方法回顾性分析3例原发性胰腺副神经节瘤的临床资料,结合国内外文献报道资料进行归纳总结.结果结合已发表文献总计35例原发性胰腺副神经节瘤,肿瘤位于胰腺头24例,胰体尾11例.瘤内有囊性灶10例(28.6%),无囊性灶25例.有功能性7例,多表现为儿茶酚胺升高相关症状,无功能性28例,多无症状,偶有腹痛,多于体检时通过影像学发现,但难以明确诊断.胰十二指肠切除10例,局部切除20例,其他治疗4例,淋巴结阳性者3例,最长随访时间72个月,均未见复发或转移.结论胰腺副神经节瘤常见于中老年女性,临床症状不典型,部分以上腹部痛为首发症状,术前明确诊断困难,建议行肿瘤完整切除及区域淋巴结清扫.

Objective To provide reference for the diagnosis and treatment of clinical primary pancreatic paraganglioma.Methods The clinical diagnosis and treatment data of 3 cases of primary pancreatic paraganglioma were retrospectively analyzed and summarized in combination with domestic and foreign literature reports.Results Combined with the published literature,there were a total of 35 cases of primary pancreatic paraganglioma,24 cases of tumors located in the head of the pancreas,11 cases of the body and tail of the pancreas.There were 10 cases(28.6%)of cystic foci in the tumor and 25 cases of no cystic foci.There were 7 patients with functional features,most of which showed symptoms related to elevated catecholamines,and 28 patients with non-functional features were mostly asymptomatic,with occasional abdominal pain,which was more than found by imaging during physical examination,but it was difficult to make a clear diagnosis.There were 10 cases of pancreaticoduodenectomy,20 cases of local resection,4 cases of other treatments,and 3 cases of lymph node positive.The longest follow-up time was 72 months,and no recurrence or metastasis was found.Conclusion Pancreatic paraganglioma is common in middle-aged and elderly female patients.The clinical symptoms are atypical.Part of the abdominal pain is the first symptom.It is difficult to make a clear diagnosis before surgery.Complete tumor resection and local lymph node dissection are recommended.