An Incidental Pancreatic Neuroendocrine Tumor within a Pancreatic Pseudocyst treated with Laparoscopic Distal Pancreatectomy

腹腔鏡胰尾切除術治療意外發現於胰臟假性囊腫內的胰臟神經內分泌腫瘤

吳益利(Edie Rosmin Wu) ； 許至偉(Chih-Wei Hsu)

《童綜合醫學雜誌》 13卷1期 (2019/06) Pp. 23-26

https://doi.org/10.3966/207135922019061301005

摘要

Pancreatic cystic lesions are a type of lesion being increasingly detected, and account for approximately 5% of pancreatic neoplasms. Cystic tumors are often misdiagnosed as pancreatic pseudocysts (PPCs). A 27-year-old man visited our clinic due to abdominal pain and fever, and was diagnosed with a PPC. Due to persistent symptoms and multiple pseudocysts, a cystic neoplasm could not be ruled out. Laparoscopic spleen-preserving distal pancreatectomy was performed and pathology examination showed a 0.7-cm pancreatic neuroendocrine tumor (NET) within a pseudocystic formation. The post-operative course was uneventful and a seven-year follow-up did not show evidence of tumor recurrence. NETs are a group of heterogeneous tumors ranging from benign to high-grade malignant. A World Health Organization classification in 2010 categorized them into NET G1, NET G2, or neuroendocrine carcinoma G3. NET is rarely associated with acute or chronic pancreatitis. Therefore, diagnostic imaging is essential in young patients with pancreatitis of unknown cause. Surgical treatment provides the only possibility of cure in cases of NET G1.

關鍵字

Neuroendocrine tumor ； Pancreatic pseudocyst ； Laparoscopic distal pancreatectomy

並列摘要

胰臟囊性病變是近年來發生率持續在增加中，它佔約5%的胰腺腫瘤。囊性腫瘤常常被誤診為胰臟偽囊腫。一名二十七歲男子前往因為胰臟假性囊腫前來求診。由於持續的症狀和多發性偽囊腫而不能排除是囊性腫瘤。所以病人接受了腹腔鏡胰尾切除術。病理結果顯示0.7 cm胰臟神經內分泌腫瘤發生於偽囊腫之內。術後恢復順利，追蹤七年內沒有發現腫瘤復發的證據。神經內分泌腫瘤是一群異質腫瘤，從良性到高度惡性的行為表現都有。2010年世界衛生組織分類為神經內分泌腫瘤G1或神經內分泌腫瘤G2或神經內分泌癌G3。神經內分泌腫瘤很少與急性或慢性胰臟炎有相關。因此，對於具有未知原因的胰臟炎的年輕患者，影像診斷上需要更加留意。同時外科治療是唯一提供神經內分泌腫瘤G1治癒的可能性。

並列關鍵字

神經內分泌腫瘤 ； 胰臟偽囊腫 ； 腹腔鏡胰尾切除術