胰腺粘液囊性肿瘤内发生间变性胰腺癌:1例报告及文献回顾。

Journal of Pancreatic Cancer Pub Date : 2017-07-01 eCollection Date: 2017-01-01 DOI:10.1089/pancan.2017.0004
Alessandro Paniccia, Robert Torphy, Kalpana Devaraj, Richard D Schulick
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引用次数: 5

摘要

背景:间变性胰腺癌(APCs)是最不常见的胰腺恶性肿瘤之一,占所有非内分泌胰腺恶性肿瘤的0.5%至7%。此外,很少有APCs发生在胰腺粘液囊性肿瘤(MCN)中。病例介绍:36岁女性,左上腹疼痛,胰尾有一个10 × 8厘米的复杂囊性肿块。囊肿细针穿刺示乳头状细胞簇,轻度细胞学异型性,囊肿液癌胚抗原>4000 ng/mL,淀粉酶25 U/L。在开放性远端胰腺切除术和脾切除术后,标本显示MCN伴浸润性高分化腺癌的多灶显微镜灶。在进一步取样后,我们发现了未分化的恶性病灶——形态上类似肉瘤,但免疫组织化学染色与间变性癌一致。患者顺利康复,目前正在接受以吉西他滨为基础的辅助化疗方案;在初步诊断后5个月,她仍然无病。结论:在这项研究中,我们描述了一个罕见的APC病例起源于一个大的胰腺MCN病变。该病例强调了对整个MCN上皮进行仔细病理评估的重要性,并增加了来自胰腺MCN病变的APC的有限的世界文献。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Anaplastic Pancreatic Carcinoma Arising Within a Mucinous Cystic Neoplasm of the Pancreas: A Case Report and a Brief Review of the Literature.

Anaplastic Pancreatic Carcinoma Arising Within a Mucinous Cystic Neoplasm of the Pancreas: A Case Report and a Brief Review of the Literature.

Anaplastic Pancreatic Carcinoma Arising Within a Mucinous Cystic Neoplasm of the Pancreas: A Case Report and a Brief Review of the Literature.

Background: Anaplastic pancreatic carcinomas (APCs) are among the least frequently encountered pancreatic malignancies, ranging from 0.5% to 7% of all nonendocrine pancreatic malignancies. Furthermore, few cases of APCs have been described arising within a pancreatic mucinous cystic neoplasm (MCN). Case Presentation: A 36-year-old female presented with left upper quadrant pain and a 10 × 8 cm complex cystic mass in the pancreatic tail. Fine needle aspiration of the cyst showed papillary clusters of cells with mild cytological atypia, cyst fluid carcinoembryonic antigen >4000 ng/mL, and amylase of 25 U/L. After an open distal pancreatectomy and splenectomy, the specimen revealed an MCN with multifocal microscopic foci of invasive well-differentiated adenocarcinoma. After additional sampling, foci of undifferentiated malignancy-morphologically resembling sarcomas but with immunohistochemical staining consistent with anaplastic carcinoma-were identified. The patient had an uneventful recovery and is currently undergoing a regimen of gemcitabine-based adjuvant chemotherapy; she remains disease-free at 5 months after initial diagnosis. Conclusions: In this study, we describe a rare case of APC originating from a large pancreatic MCN lesion. This case underlines the importance of scrupulous pathological evaluation of the entire MCN epithelium and adds to the limited world literature of APC originating from pancreatic MCN lesions.

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