Huge Periampullary Tumors Simulating Hepatic Hilar Tumors - A Report of Three Cases

少數較為罕見的壺腹周圍腫瘤因為生長緩慢且缺乏特異症狀，於初次診斷時體積便已相當龐大，在術前腹部電腦斷層上常需要與較具侵犯性的肝門部位腫瘤作區分。本文報告二例胰臟神經內分泌腫瘤與一例十二指腸腸胃基質細胞瘤，其術前影像學檢查與肝門部位腫瘤有類似的表現，經剖腹探查後確認其來源並以幽門保留式胰頭十二指腸切除術成功地切除。這些腫瘤與較為常見的胰頭部癌相比，不僅切除率較高，預後亦較佳，因此對於這一類病人，應於術前綜合各項臨床發現及影像檢查，與較常見但預後不良的肝門腫瘤或胰頭腫瘤做鑑別診斷，從而採取較為積極的治療方式，以達到更好的治療效果。

關鍵字

壺腹周圍腫瘤；神經內分泌腫瘤；胰臟腫瘤；腸胃基質細胞瘤；十二指腸腫瘤

並列摘要

Difficulties in surgical decision-making may arise when periampullary tumors are large enough to reach the hepatic hilar region, thus, making them indistinguishable from tumors originating from this part of the body on abdominal computed tomography. We present three cases of periampullary tumors (one gastrointestinal stromal tumor of the duodenum, two endocrine cell tumors of the pancreas) with preoperative image findings resembling hepatic hilar tumors. All three of the patients remained rather asymptomatic in spite of the presence of large tumors (maximal diameter of tumors ranging from 7 cm to 25 cm). Serum levels of alpha-fetoprotein, carcinoembryonic antigen, and carcinoantigen 19-9 were all within reference ranges. Image studies showed no vascular invasion. All tumors were successfully resected using pylorus-preserving pancreaticoduodenectomy. In contrast to the better-understood adenocarcinomas, most of these relatively rare periampullary tumors can be resected with promising prognoses. Therefore, it is important to identify and treat the patients with these tumors properly rather than subject the patients to conservative treatment just because of the size and location of the tumors.

並列關鍵字

periampullary tumor ； neuroendocrine tumor ； pancreatic tumor ； gastrointestinal stromal tumor ； duodenal tumor

國際替代計量

Huge Periampullary Tumors Simulating Hepatic Hilar Tumors - A Report of Three Cases

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