胰腺神经鞘瘤50例  

Analysis of 50 cases of pancreatic schwannoma

作　　者：李新星[1] 郑继慧[2] 戴朝六[1] 闫兆鹏[1] 张逸婧[1] 

机构地区：[1]中国医科大学附属盛京医院肝胆外科,辽宁省沈阳市110004 [2]中国医科大学附属第四医院,辽宁省沈阳市110032

出　　处：《世界华人消化杂志》2007年第25期2741-2746,共6页World Chinese Journal of Digestology

摘　　要：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.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 schwannoma, 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 nature of the tumor was not specified in 7 patients. Forty-nine patients received operative therapy. Thirteen patients underwent a Whipple operation, 12 distal pancreatectomy, 12 local resection, 8 simple enucleation, and in 2 patients the surgical procedure was not specified. The tumor in 1 patient was unresectable. One patient underwent 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 diagnosis 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.

关 键 词：胰腺 神经鞘瘤 诊断 治疗 

分 类 号：R735.9[医药卫生—肿瘤]