Pancreatic Neuroendocrine Tumour with Cystic Change and Coexisting Escherichia Coli Infection: Report of a Case

胰臟囊狀病灶之鑑別診斷，對臨床醫師而言是項挑戰。我們報告一位四十九歲女性，因發燒及上腹疼痛來求診。腹部超音波及電腦斷層檢查發現胰臟尾部囊狀病灶，抽吸液經培養證實為大腸桿菌感染，進一步手術切除，病理證實為胰臟神經內分泌腫瘤胰臟胰島細胞腫瘤併囊狀變化，術後追蹤，預後良好。回顧文獻，本病例為首例胰臟神經內分泌腫瘤胰臟胰島細胞腫瘤併囊狀變化及細菌感染之報告。

關鍵字

胰臟神經內分泌腫瘤；胰臟囊狀病灶

並列摘要

We report a case of pancreatic neuroendocrine tumour (NET) with cystic change coexistent with secondary infection in a 49-year-old woman. She complained of fever, chills, nausea, vomiting, and left upper quadrant abdominal pain for two days. An abdominal computed tomography showed a huge cystic lesion with an irregular thick wall in the pancreas tail. Percutaneous echo-guide needle aspiration was performed to treat the suspicious infectious cystic lesion and the culture of the aspirate showed the presence of Escherichia coli. A distal pancreatectomy was performed and an 11×10 cm cystic mass with hemorrhage and necrosis was identified in the pancreas tail. The pathologic diagnosis was pancreatic NET with hemorrhage and cystic change. After the operation and antibiotic treatment, the patient was discharged on the 18(superscript th) postoperative day. Pancreatic NET with bacterial infection is extremely rare. To our knowledge, we report the first case in the literature showing cystic change of pancreatic NET with bacterial infection. We emphasize that Pancreatic NET with cystic change with secondary infection should be considered in the differential diagnosis among all cystic tumors of the pancreas, especially in the initial presentations of abdominal pain, fever or other signs of sepsis.

並列關鍵字

neuroendocrine tumour ； pancreatic cystic neoplasm

國際替代計量

Pancreatic Neuroendocrine Tumour with Cystic Change and Coexisting Escherichia Coli Infection: Report of a Case

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