中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (01): 47-49.

• 论著 • 上一篇    下一篇

肾透明细胞癌胰腺转移瘤3例临床分析

张 磊，纪 元，楼文晖，王单松，许雪峰，靳大勇   

  1. 复旦大学附属中山医院普外科胰腺肿瘤专业组，上海 200032
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2010-01-12 发布日期:2010-01-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2010-01-12 Published:2010-01-12

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摘要：

目的 探讨肾透明细胞癌胰腺转移瘤的临床特点。方法 分析复旦大学附属中山医院自2003?01?01至2009?05?31病理确诊肾透明细胞癌胰腺转移3例病人的临床资料。结果 （1）肾透明细胞癌胰腺转移瘤的B超表现为低回声团块，难以与胰腺癌鉴别；而在CT动脉期可表现为增强病灶，又难以与神经内分泌肿瘤鉴别。（2）术后病理大体标本表现为边界清晰，切面灰黄，伴有灰红色坏死区域肿块。镜下为细胞质量多呈透明色的成片状排列。（3）1例病人术后11个月死亡，另2例病人随访至2009年5月，术后生存时间分别为21个月和2个月，现仍在继续随访中。结论 肾透明细胞癌胰腺转移瘤的共同特点为B超表现为低密度团块，CT表现为动脉期明显增强病灶。术前诊断主要依靠既往病史及CT检查。根治性胰腺转移瘤切除术后生存状况仍难确定，通常认为若无复发、转移，则有望获得长期生存。

关键词: 胰腺转移瘤, 肾透明细胞癌

Abstract:

Research for 3 cases on the clinical characteristics of pancreatic metastasis tumor from renal clear cells ZHANG Lei, JI Yuan, LOU Wen-hui, et al. Pancreatic Tumor Group, Department of General Surgery, Zhongshan Hospital of Fu Dan University, Shanghai 200032, China Corresponding author: JIN Da-yong, E-mail: dyjin524@yahoo.com.cn Abstract Objective Analyze and research on the clinical feathers of pancreatic metastases of renal clear cell carcinoma. Methods Collect 3 cases which were diagnosed as pancreatic metastases of renal clear cell carcinoma by pathology from January 1st, 2003 to May 31st, 2009, retrospectively analyze the clinical manifestations, physical signs, B-ultrasound and CT findings, postoperative pathology as well as the survival time after operation of pancreatic metastases of renal clear cell carcinoma. Results (1) B-ultrasound shows masses with low density, and they are difficult to distinguish from pancreatic cancer.; According to CT arterial phase, pancreatic metastases of renal clear cell carcinoma can be showed as enhanced lesions which are difficult to distinguish from neuroendocrine tumors. (2) According to the general pathology after operation, they are showed as masses with clear boundary, sallow section, accompanied with grey and red necrotic region; Cells under microscopes show numerous with transparent color (cytoplasm), and cells align like a sheet. (3) One sample patient died 11 months after the operation, and others were alive with our research until May 2009 with survival time of 21 months and 2 months respectively, and they are still alive with our research. Conclusion The follows are the common clinical Feathers of pancreatic carcinoma metastasis in renal clear cells : B-ultrasound shows masses with low density; CT arterial phase shows masses as enhanced lesions; Preoperative diagnosis basically is on the ground of medical history and CT manifestation. It’s still difficult to confirm the survival time after radical excision, People can normally survive for a long time if there’s no further metastasis happened.

Key words: pancreatic metastasis, renal clear cell carcinoma