19例胰腺原发少见肿瘤的临床特征及诊治分析  

The clinical features,diagnosis and treatment analysis of 19 cases of primary rare pancreatic tumor

作　　者：王道蓉[1] 王玮[1] 童旭东[1] 占义军[1] 

机构地区：[1]湖北省襄阳市中心医院湖北文理学院附属医院消化内科,湖北襄阳441021

出　　处：《胃肠病学和肝病学杂志》2016年第2期219-222,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的总结分析胰腺原发少见肿瘤的临床特征和诊治方法,以提高对胰腺原发少见肿瘤的认识。方法回顾性分析湖北省襄阳市中心医院2012年1月-2015年3月经手术或超声内镜（endoscopic ultrasonography,EUS）下穿刺病理证实的19例胰腺原发少见肿瘤患者的临床资料。结果肿瘤位于胰头部9例,胰体4例,胰尾部5例,胰体尾部2例（其中1例患者胰头和胰体各有1个肿块）直径2.5~25.0 cm,平均（8.0±5.2）cm;临床表现为腹痛12例,反复发作低血糖1例,体表触及包块1例,无明显症状影像学发现占位3例,纳差1例,腹痛脂肪泻伴血糖升高1例;14例行手术完整切除,1例行姑息性手术,1例仅行剖腹探查肿块活检,2例放弃治疗,1例转院;17例患者完成随访,其中1例死亡,2例失访。结论胰腺原发少见肿瘤的早期临床症状不典型,影像学检查对其诊断有辅助意义,治疗以手术为主,部分需辅以放化疗。Objective To analyze the clinical characteristics and methods of diagnosis and treatment of primary rare pancreatic tumors, in order to improve the understanding of primary rare pancreatic tumors. Methods Nineteen cases of primary rare pancreatic tumors confirmed by surgical or endoscopic ultrasonography （EUS） pathologically in Xiangyang Central Hospital from Jan. 2012 to Mar. 2015 were analyzed retrospectively. Results Nine cases of tumors were located in the pancreatic head, 4 cases in the pancreatic body and 5 cases in the pancreatic tail, 2 cases in the pancreatic body and tail （1 case in the pancreatic head and body both with a mass） the diameter of tumor ranged was 2.5 ~ 25.0 cm [ average （8.0 _＋ 5.2）cm]. The clinical manifestations were abdominal pain in 12 cases, recurrent hypoglycemia in 1 case, abdominal mass in 1 case, 3 cases had no obvious symptoms, 1 case of anorexia, 1 case of abdominal pain, ste- atorrhea and hyperglycemia. Fourteen patients underwent complete resection, 1 case underwent palliative surgery, 1 case underwent laparotomy tumor biopsy, 2 cases gave up treatment, 1 case transferred to superior hospital. Seventeen cases were followed up, 1 case died, 2 cases were lost. Conclusion The early clinical symptoms of primary rare pancreatic tumor are atypical and the imaging examination has auxiliary significance in the diagnosis. The main treetment is surgery , and some need to be supplemented by radiotherapy and chemothrtapy.

关 键 词：胰腺少见肿瘤 实性假乳头状瘤 黏液性囊腺瘤 浆液性囊腺瘤 间质瘤 神经内分泌肿瘤 孤立性纤维性肿瘤 

分 类 号：R735.9[医药卫生—肿瘤]