胰腺实性假乳头状瘤的诊断和治疗

目的 总结胰腺实性假乳头状瘤的诊断和治疗经验。方法 对2000年8月至2004年2月收治的12例胰腺实性假乳头状瘤病例进行回顾性研究。结果 12例患者年龄13—53岁,平均29．1岁,其中女性11例,男性1例。肿瘤位于胰头6例,胰颈部1例,胰体尾部5例。无特异性临床表现。B超发现胰腺低回声实性或囊实性占位。CT检查发现胰腺低密度占位病变,增强扫描肿瘤周边出现明显不规则强化。血清肿瘤标记物均为阴性。2例行胰十二指肠切除术,3例行胰头肿物切除术及胰管空肠吻合术,1例行胰头肿物切除术,1例行胰腺节段切除术及远端胰管空肠吻合术,5例行胰体尾及脾切除术。对10例患者进行随访,平均随访时间14．3个月,均未发现肿瘤复发转移。结论 胰腺实性假乳头状瘤是一种罕见的低度恶性胰腺肿瘤,多发于青年女性,切除肿瘤后能获得良好的预后。

The diagnosis and treatment of solid-pseudopapillary tumor of pancreas

Objective To summarize the experience of diagnosis and treatment in solid pseudopapillary tumor of pancreas (SPT). Method Retrospectively analyzed 12 cases of SPT diagnosed between 2000 Augest and 2004 February in Peking Union Medical College Hospital. Results The average age of these 12 cases was 29 1, including 11 women and 1 men. The tumors of 6 cases were located in the pancreatic head, one tumor was in the neck of pancreas and 5 tumors were in the body and tail of pancreas. There were no characteristic clinical manifestations. Solid and solid cystic masses of low echo were found in pancreas in ultrasonic examinations. CT scan found masses of low density in pancreas, while irregular enhancement appeared in the circumference of all tumors in enhanced CT scan sequences. Tumor markers in patients' serum were all negative. Pancreaticoduodenectomy were performed in 2 cases. Resection of tumors and pancreaticojejunostomy were performed in 3 cases. Simple resection of tumor was performed in 1 case. Segmental pancreatectomy and pancreaticojejunostomy was performed in one patient. Five patients underwent distal pancreatectomy and spleen resection. Ten patients were followed up with the average time of 14.3 months. No evidence of relapses and metastasis in these cases was found. Conclusion Solid pseudopapillary tumor of pancreas was one of rare pancreatic neoplasm with low malignant potential, affecting primarily young women. Complete resection resulted in long term survival.