摘要
目的:讨论孤立性纤维性肿瘤(solitary fibrous tumor,SFT)的临床特征、病理学表现、影像学表现、诊断方法、鉴别诊断、治疗及预后,以提高临床医生对此病的认识及诊治水平。方法:报道1例术后肿瘤2次复发的胰腺恶性SFT的临床病理资料并文献复习。结果:患者女性,59岁,以"体检发现胰尾部肿物10天"为主诉首次入院,入院后诊断为胰体部占位,行胰体尾切除、脾切除术,术后石蜡病理提示胰体尾交界性梭形细胞肿瘤,考虑孤立性纤维性肿瘤。术后5月余复查,肿瘤复发于左上腹网膜囊内,再次手术切除复发肿物,术后石蜡病理提示交界性或低度恶性孤立性纤维性肿瘤。距二次术后4月余复查,肿瘤再次复发于左上腹网膜囊内,再次予手术切除肿物,术后石蜡病理提示交界性或低度恶性孤立性纤维性肿瘤。结论:胰腺恶性SFT病例极其罕见,术后复发者更是少之又少,确诊主要依靠病理组织形态学及免疫组化标记,并与其他相关性疾病加以鉴别,治疗方法以手术完全切除肿物为主,注意定期复查及远期随访。
Objective： To discuss the clinical features,pathologic findings,imaging findings,diagnostic methods,differential diagnosis,treatment and prognosis of solitary fibrous tumor（ SFT）,to improve the diagnosis and treatment of this disease. Methods： Review 1 case of postoperative recurrence of pancreatic malignant SFT and its clinical and pathological data,then review literature. Results： The patient was a female with 59 years old,the first admission for the physical examination found pancreatic tail tumor for 10 days. Line-related imaging examination showed pancreatic body mass. After admission,pancreatic body resection and splenectomy were performed. Postoperative pathology prompted pancreas tail junction borderline spindle cell tumors,which was considered as isolated fibrous tumors. After5 months of recurrence of tumor recurrence in the left upper quadrant of the omental bursa,once again surgical resection of the tumor,postoperative pathology suggested borderline or low degree of malignant mesenchymal tumors,which was considered as isolated fibrous tumors. From the second postoperative more than 4 months after the recurrence of tumor recurrence in the left upper quadrant of the omental bursa,to surgical resection of the tumor,postoperative pathology suggested intraperitoneal junctional or low degree of malignant solitary fibrous tumors. Conclusion： The SFT of the pancreas is extremely rare,and the recurrence is very few. The diagnosis is mainly based on the histopathology and immunohistochemical markers,which should be identified with other related diseases. The treatment is mainly based on the complete resection of the tumor,and regular review and long-term follow-up.
作者
王熠辉
姚威
张鑫
孔祥子
王宝胜
Wang Yihui;Yao Wei;Zhang Xin;Kong Xiangzi;Wang Baosheng(Department of Pancreatic Endocrine Surgery,Shen~ing Hospital of China Medical University,Liaoning Shenyang 110004,China.)
出处
《现代肿瘤医学》
CAS
2018年第17期2721-2724,共4页
Journal of Modern Oncology
关键词
胰腺孤立性纤维性肿瘤
手术治疗
免疫组化
复发
pancreatic solitary fibrous tumors
surgical treatment
immunohistoehemistry
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