胰腺孤立性纤维性肿瘤1例报告及文献复习

Prilozi Pub Date : 2016-11-01 DOI:10.1515/prilozi-2016-0024
L. Spasevska, V. Janevska, V. Janevski, Biljana Noveska, J. Zhivadinovik
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引用次数: 3

摘要

胰腺是一种极其罕见的腹部孤立性纤维性肿瘤(SFT)。在根据症状和/或机械并发症作出诊断之前,它通常在很长一段时间内无症状地生长。由于罕见和非特异性的临床表现,该实体的诊断具有挑战性。我们报告一名47岁的男性,过去两周有进行性上腹部疼痛史,并伴有黄疸,入院接受进一步检查。根据影像学表现怀疑为囊腺癌,并行胰十二指肠切除术。胰腺切除部分包含3.5 × 2 × 1.8 cm边界清楚但未包被的白色肿瘤肿块,切面光滑,肿瘤内及邻近胰腺组织内有囊性成分和导管扩张。根据组织学和免疫染色,诊断为孤立性纤维性肿瘤。术后1周,患者因手术并发症死亡。显微镜和免疫组织化学检查是准确诊断胰腺囊性SFT的必要条件。由于关于胸膜外定位的SFT的生物学行为的数据有限,作者建议如果不符合恶性标准,则对SFT进行临床随访治疗。
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Solitary Fibrous Tumor of the Pancreas: A Case Report and Review of the Literature
Abstract Pancreas is an extremely rare abdominal localization of the solitary fibrous tumor (SFT). It usually grows asymptomatically for a long time before a diagnosis can be made on the basis of symptoms and/or mechanical complications. Due to the rarity and nonspecific clinical presentation, this entity is diagnostically challenging. We present a 47-year-old man with a history of progressive epigastric pain for the last two weeks, and jaundice, who was admitted to hospital for further investigation. Cystadenocarcinoma was suspected based on the radiologic findings, and a pancreatoduodenectomy was performed. The removed portion of the pancreas contained a 3.5 × 2 × 1.8 cm well-circumscribed, but not encapsulated white tumor mass with smooth cut surface, cystic component and duct dilatation within the tumor and within the adjacent pancreatic tissue. Based on the histology and immunostaining profile, a diagnosis of the solitary fibrous tumor was made. One week post-operatively, the patient died due to surgical complications. Microscopic and immunohistochemical examinations are necessary for accurate diagnosis of cystic SFT of the pancreas. Because there is limited data regarding the biological behavior of SFT with extra-pleural localization the authors recommend clinical follow-up for SFT treatment if the criteria of malignancy are not met.
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