中国实用外科杂志

中国实用外科杂志

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胰腺间质瘤伴肝转移1例报告并文献复习

吕雪琰，鄂长勇，姚小晓，李    航，杨永生，张学文   

  1. 吉林大学中日联谊医院肝胆胰外科，吉林长春130033
  • 出版日期:2015-04-01 发布日期:2015-03-31

  • Online:2015-04-01 Published:2015-03-31

摘要：

目的    探讨胰腺间质瘤的临床表现、诊断、治疗及预后。方法    回顾性分析2014年5月吉林大学中日联谊医院肝胆胰外科收治的1例胰腺间质瘤伴肝转移病人的临床资料，并结合国内外文献进行总结。结果    病人入院后结合相关辅助检查，术前诊断为胰腺恶性肿瘤伴肝转移。术中快速病理检查报告考虑胰腺癌肝转移可能性大，遂行胰腺肿瘤放射性125I粒子植入术，肝脏肿瘤行微波固化术。术后病理检查报告为胰腺间质瘤伴肝转移。术后口服甲磺酸伊马替尼联合注射胸腺肽-α治疗。术后6个月复查腹部CT提示胰腺肿物较前未见明显变化，超声示肝脏毁损灶无变化，随访至今。结论    胰腺间质瘤非常罕见，临床症状不典型，肿瘤标记物多正常。诊断有赖于病理检查及免疫组化检测。对于肿瘤细胞核分裂像数量>10个/50HPF的病人，存在术后复发和转移的高风险，建议给予甲磺酸伊马替尼进行辅助治疗。

关键词: 胰腺间质瘤, 肝转移

Abstract:

Pancreatic stromal tumor: A report of 1 patient and literatures’ review        LV Xue-yan, E Chang-yong, YAO Xiao-xiao, et al. Department of Hepatobiliary and Pancreatic Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China
Corresponding author: ZHANG Xue-wen, E-mail: zxw515@sohu.com
Abstract    Objective    To study the clinical manifestations, diagnosis, treatment and prognosis of pancreatic stromal tumor. Methods    The clinical data of one patient with pancreatic stromal tumor combined with hepatic metastases admitted in May,2014 in China-Japan Union Hospital of Jilin University was analyzed retrospectively. The domestic and foreign literatures were reviewed and summarized. Results    Combined with the related auxiliary examination, the patient was diagnosed as pancreatic cancer with liver metastasis. Pancreatic cancer 125I radioactive particles implantation and microwave coagulation for liver mass were performed. Postoperative pathological report supported stromal tumors by immune markers. Postoperative treatment combined imatinib  mesylate and thymosin. Six months after operation，the abdominal CT showed there was no change in the pancreatic mass and the ultrasoud showed the liver lesion had no change. The patient was followed up to the present. Conclusion    The pancreatic stromal tumor is rare, and its clinical symptoms are not typical. Tumor markers are often normal. Diagnosis depends on pathological and immunohistochemical detection. For those patients that the tumor cell nucleus mitotic figures are more than 10 /50 HPF , risk of postoperative recurrence and metastasis are high. Therefore imatinib mesylate is advised for the adjuvant therapy.

Key words: pancreatic stromal tumor, liver metastasis