胰腺神经鞘瘤50例

目的:分析胰腺神经鞘瘤的特点并探讨其诊治方法.方法:对文献上报告的49例及我院收治的1例胰腺神经鞘瘤患者的临床特点进行回顾性分析.结果:胰头病变25例,胰体9例,胰体/尾部6例,胰尾部5例,胰头/体部2例,定位不明的2例,胰颈部1例.实性肿物18例,囊性25例,7例患者肿瘤的性质不能确定.49例患者手术切除,胰十二指肠切除术13例,远端胰腺切除术12例,肿物局部切除术12例,单纯肿物核除术8例,术式不明2例,肿物无法切除1例,活检1例,拒绝手术1例.随访时间最长的达到9a,无肿瘤复发和转移.结论:胰腺神经鞘瘤术前诊断困难,绝大部分为良性,恶性少见,确诊靠病理,良性者可行肿瘤核除术,恶性者可根治性切除,术中快速病理切片有助于决定手术方式.

Analysis of 50 cases of pancreatic schwannoma

AIM:To analyze the incidence of pancreatic schwannoma and investigate its diagnosis and treatment. METHODS:A retrospective study of clinical data from 50 patients with pancreatic schwanno- ma. RESULTS:The lesion was located in the head of pancreas in 25 patients,the body in 9 (18%), the body and tail in 6,the tail in 5,the head and body in 2,the neck in 1,and the location was not specified in 2 patients.Solid tumors were found in 18 patients,cystic tumors in 25,and the na- ture of the tumor was not specified in 7 patients. Forty-nine patients received operative therapy. Thirteen patients underwent a Whipple opera- tion,12 distal pancreatectomy,12 local resection, 8 simple enucleation,and in 2 patients the surgi- cal procedure was not specified.The tumor in 1 patient was unresectable.One patient under- went biopsy.One patient refused surgery.The longest follow-up was 9 years,and there have been no reports of local recurrence or metastasis. CONCLUSION:Preoperative diagnosis of pancreatic schwannoma is difficult.Definite di- agnosis depends on pathological examination. Benign tumors can be effectively treated by lo- cal excision but those with malignancy should be treated by simple enucleation.Intraoperative frozen sections are useful for determining which kind of operation should be undertaken.