胰腺混合性腺泡-神经内分泌癌并肝转移误诊分析

目的探讨胰腺混合性腺泡-神经内分泌癌的生物学特性及临床特征。方法回顾分析1例胰腺混合性腺泡-神经内分泌癌并肝转移的临床资料。结果患者因上腹部不适10个月余，多饮、多尿、消瘦2个月入院。曾在外院就诊诊断为胰腺癌肝脏转移、继发性糖尿病、重度贫血。予相应治疗，多饮、多尿、消瘦症状有所缓解，但上腹部症状无改善，为进一步诊治转我院。经实验窀、腹部CT及MRI检查初步诊断：胰腺头颈部占位、肝脏多发占位原因待查；胰腺体尾部囊肿；脾大，门脉高压；继发性糖尿病；重度贫血。行剖腹探查术，术后病理诊断胰腺混合性腺泡-神经内分泌癌并肝脏多发转移。结论胰腺混合性腺泡-神经内分泌临床罕见，缺乏特异性临床表现，影像学检查可为其定性定位诊断提供依据，病理检查是确诊主要方法。

Misdiagnosis Analysis of Pancreatic Mixed Acinar-Neuroendocrine Carcinoma Combined with Liver Metastasis

Objective To explore the biological characteristics and clinical features of pancreatic mixed acinar-neuroendocrine carcinoma.Methods The clinical data of a patient with pancreatic mixed acinar-neuroendocrine carcinoma combined with liver metastasis was retrospectively analyzed.Results The patient was admitted for upper abdominal discomfort for 10 months,polydipsia,polyuria and weight loss for 2 months.The patient was diagnosed as having pancreatic cancer combined with liver metastasis,secondary diabetes,and severe anemia.The patient was given the appropriate treatment in other hospitals.The symptoms of polydipsia,polyuria and weight loss symptoms were alleviated but the upper abdominal symptom did not improve.The patient was admitted into our hospital for further diagnosis and treatment by laboratories,abdominal CT and MRI examinations.The initial diagnosis was a preliminary placeholder in the pancreatic head and neck,liver multiple placeholder of unknown origin,cyst of pancreatic body and tail,splenomegaly,portal hypertension,secondary diabetes and severe anemia.The diagnosis after laparotomy was pancreatic mixed acinar-neuroendocrine carcinoma combined with liver metastasis.Conclusion Pancreatic mixed acinar-neuroendocrine carcinoma is a rare disease and with no specific clinical symptoms.Iconography examination can provide a basis for localization diagnosis and pathological examination is the main method to confirm diagnosis.