P. Leszczyńska, M. Sobocińska, K. Ustymowicz, W. Romańczyk
{"title":"胰腺实性假乳头状肿瘤。病例报告。","authors":"P. Leszczyńska, M. Sobocińska, K. Ustymowicz, W. Romańczyk","doi":"10.5604/01.3001.0053.7467","DOIUrl":null,"url":null,"abstract":"Introduction: Solid pseudopapillary neoplasm ofthe pancreas (SPN) is a rare, low-grade malignanttumour that accounts for approximately 1–3% of allexocrine tumours. It usually occurs in teenagers oryoung women below 40 years. Most SPNs areasymptomatic or minimally symptomatic andincidentally found by imaging. The most commonclinical symptoms are abdominal pain andabdominal tumour.Case presentation: A 41-year-old woman withmorbid obesity and type 2 diabetes was admitted tothe hospital with upper abdominal pain, vomiting,and diarrhoea. The ultrasound found a cystic lesionin the tail of the pancreas. Subsequent MRIexamination revealed polycyclic litho cystic tumour63x 52 mm, 72mm c-c within the tail of the pancreas.Afterwards, the pancreatic tail with the tumour waslaparoscopically resectioned. Histopathologicalevaluation of collected tumour tissues found a solidpseudopapillary neoplasm (SPN) in those pancreaticcells. Subsequently, the patient was prescribed anadditional 2U of Lispro insulin before each andCreon enzyme replacement therapy for the SPN. Amonth after the procedure, the patient was admittedto the ICU with sharp abdominal pain, abdominalcramps, and high inflammatory markers. She wassuccessfully treated for acute pancreatitis anddischarged after ten days. The patient is in stablecondition and continues the Creon treatment.Conclusions: SPN can be detected by ultrasound,computed tomography, magnetic resonanceimaging, and positron emission tomography. SPN isa type of cancer with low malignancy potential dueto the low metastasis and vascular invasionprobability. Metastases to other organs have beenreported in 15% to 20% of SPN. Distant metastasesare typically found in the liver and lymph nodes, butthe peritoneum, omentum, and lungs can also beinvolved. The treatment of choice is pancreaticsurgery, including resection of distant metastases.The 10-year disease-specific survival rate is 96%.","PeriodicalId":138155,"journal":{"name":"Progress in Health Sciences","volume":"2 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Solid pseudopapillary neoplasm of the pancreas. Case report.\",\"authors\":\"P. Leszczyńska, M. Sobocińska, K. Ustymowicz, W. Romańczyk\",\"doi\":\"10.5604/01.3001.0053.7467\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: Solid pseudopapillary neoplasm ofthe pancreas (SPN) is a rare, low-grade malignanttumour that accounts for approximately 1–3% of allexocrine tumours. It usually occurs in teenagers oryoung women below 40 years. Most SPNs areasymptomatic or minimally symptomatic andincidentally found by imaging. The most commonclinical symptoms are abdominal pain andabdominal tumour.Case presentation: A 41-year-old woman withmorbid obesity and type 2 diabetes was admitted tothe hospital with upper abdominal pain, vomiting,and diarrhoea. The ultrasound found a cystic lesionin the tail of the pancreas. Subsequent MRIexamination revealed polycyclic litho cystic tumour63x 52 mm, 72mm c-c within the tail of the pancreas.Afterwards, the pancreatic tail with the tumour waslaparoscopically resectioned. Histopathologicalevaluation of collected tumour tissues found a solidpseudopapillary neoplasm (SPN) in those pancreaticcells. Subsequently, the patient was prescribed anadditional 2U of Lispro insulin before each andCreon enzyme replacement therapy for the SPN. Amonth after the procedure, the patient was admittedto the ICU with sharp abdominal pain, abdominalcramps, and high inflammatory markers. She wassuccessfully treated for acute pancreatitis anddischarged after ten days. The patient is in stablecondition and continues the Creon treatment.Conclusions: SPN can be detected by ultrasound,computed tomography, magnetic resonanceimaging, and positron emission tomography. SPN isa type of cancer with low malignancy potential dueto the low metastasis and vascular invasionprobability. Metastases to other organs have beenreported in 15% to 20% of SPN. Distant metastasesare typically found in the liver and lymph nodes, butthe peritoneum, omentum, and lungs can also beinvolved. 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引用次数: 0
摘要
胰腺实性假乳头状肿瘤(SPN)是一种罕见的、低级别的恶性肿瘤,约占内分泌肿瘤的1-3%。它通常发生在青少年或40岁以下的年轻女性。大多数spn无症状或症状轻微,偶然通过影像学发现。最常见的临床症状是腹痛和腹部肿瘤。病例介绍:一名41岁女性,患有病态肥胖和2型糖尿病,因上腹痛、呕吐和腹泻入院。超声检查发现胰腺尾部有一个囊性病变。随后的mri检查显示胰腺尾部有63x 52 mm, 72mm c-c的多环性结石囊性肿瘤。随后,经腹腔镜切除胰腺尾部肿瘤。对收集的肿瘤组织进行组织病理学检查,在这些胰腺细胞中发现了一个实性假乳头状肿瘤(SPN)。随后,患者在每次治疗前再加用2U Lispro胰岛素和creon酶替代治疗SPN。手术一个月后,患者因剧烈腹痛、腹部痉挛和高炎症指标入院ICU。她的急性胰腺炎被成功治疗,十天后出院。患者情况稳定,继续进行Creon治疗。结论:SPN可通过超声、计算机断层扫描、磁共振成像和正电子发射断层扫描检测。SPN是一种低转移性、低血管侵袭性的恶性肿瘤。据报道,15%至20%的SPN转移到其他器官。远处转移通常发生在肝脏和淋巴结,但也可累及腹膜、大网膜和肺部。治疗的选择是胰腺手术,包括远处转移的切除。10年疾病特异性生存率为96%。
Solid pseudopapillary neoplasm of the pancreas. Case report.
Introduction: Solid pseudopapillary neoplasm ofthe pancreas (SPN) is a rare, low-grade malignanttumour that accounts for approximately 1–3% of allexocrine tumours. It usually occurs in teenagers oryoung women below 40 years. Most SPNs areasymptomatic or minimally symptomatic andincidentally found by imaging. The most commonclinical symptoms are abdominal pain andabdominal tumour.Case presentation: A 41-year-old woman withmorbid obesity and type 2 diabetes was admitted tothe hospital with upper abdominal pain, vomiting,and diarrhoea. The ultrasound found a cystic lesionin the tail of the pancreas. Subsequent MRIexamination revealed polycyclic litho cystic tumour63x 52 mm, 72mm c-c within the tail of the pancreas.Afterwards, the pancreatic tail with the tumour waslaparoscopically resectioned. Histopathologicalevaluation of collected tumour tissues found a solidpseudopapillary neoplasm (SPN) in those pancreaticcells. Subsequently, the patient was prescribed anadditional 2U of Lispro insulin before each andCreon enzyme replacement therapy for the SPN. Amonth after the procedure, the patient was admittedto the ICU with sharp abdominal pain, abdominalcramps, and high inflammatory markers. She wassuccessfully treated for acute pancreatitis anddischarged after ten days. The patient is in stablecondition and continues the Creon treatment.Conclusions: SPN can be detected by ultrasound,computed tomography, magnetic resonanceimaging, and positron emission tomography. SPN isa type of cancer with low malignancy potential dueto the low metastasis and vascular invasionprobability. Metastases to other organs have beenreported in 15% to 20% of SPN. Distant metastasesare typically found in the liver and lymph nodes, butthe peritoneum, omentum, and lungs can also beinvolved. The treatment of choice is pancreaticsurgery, including resection of distant metastases.The 10-year disease-specific survival rate is 96%.