- 期刊
慢性鈣化性胰臓炎併發胰臓癌－四例報告
Chronic Calcified Pancreatitis Coexisting with Pancreatic Carcinoma: Case Reports
摘要
胰實質鈣化或胰石一向被認為足慢性胰臟炎的徵候，而慢性胰臟炎和胰臟癌的鑑別診斷本來就相當困難，因此若使性鈣化性胰臟炎久合併胰臟癌發生時，常造成誤診或延遲診斷，本文提出四例慢性鈣化性臓職炎合併胰臟癌的病例報告，其中除第三例外，都是在傍性胰臟炎的診斷下，接受手術治療，而後才發現有腫瘤的存在。我們建議對慢性鈣化性胰臟炎患者，特別是無酒精成癮病史，臨床出向黃疸，反覆性腹痛，糖尿病突然惡化及體重減輕等情形時，宜再利用電腦斷層掃描細切(thin-cut)，配合CEA, A19—9等腫瘤標記，必要時再以超音波或電腦斷層掃描指引施行胰臟細針抽取細胞檢查，來提高胰臟癌的診斷率。
並列摘要
Previously, pancreatic calcifications or stones were frequently taken as one of the important signs of chronic pancreatitis. Hence, the diagnosis of calcified pancreatitis with pancreatic carcinoma has usually been missed or delayed. We report four cases of chronic calcified pancreatitis coexisting with pancreatic carcinoma. Three of them were initially diagnosed as chronic pancreatitis but were subsequently confirmed to have coexisting pancreatic carcinomas following surgical intervention. It is suggested that in the presence of chronic pancreatic calcifications or stones coexisting pancreatic cancer should be keep in mind. The differential diagnosis of chronic calcified pancreatitis and pancreatic carcinoma is usually difficult, thus a combination of multiple diagnostic tools must be employed to ascertain the presence of coexisting pancreatic carcinoma.
延伸閱讀
- Hsu, M. T., Chang, T. T., Lin, P. W., Tsai, H. M., Lee, W. Y., & Lin, X. Z. (1995). 慢性鈣化性胰臟炎併發胰臟癌─病例報告. 慈濟醫學雜誌, 7(1), 59-65. https://doi.org/10.6440/TZUCMJ.199503.0059
- Lin, Y. T., Wu, B. S., Yang, S. F., & Chen, H. C. (2009). 惡性肋膜間皮瘤併發單獨性的胰臟轉移－病例報告. The Kaohsiung Journal of Medical Sciences, 25(7), 395-400. https://www.airitilibrary.com/Article/Detail?DocID=1607551X-200907-200907170052-200907170052-395-400
- 詹佩欣、呂碧鴻、陳慶餘、梁繼權（2004）。Osler-Weber-Rendu症候群合併胰臟血管瘤及急性胰臟炎之病例分析。臺灣家庭醫學研究，2(1)，38-45。https://doi.org/10.29475/TFMR.200401.0005
- Huang, Y. W., Yang, J. C., Chang, Y. L., Tsang, Y. M., & Wang, T. H. (2005). 急性胰臟炎合併性Budd-Chiari氏症候群為小細胞肺癌之最初表現. Journal of the Formosan Medical Association, 104(6), 431-435. https://doi.org/10.29828/JFMA.200506.0009
- Huang, C. Y., Tsai, Y. H., Lee, C. H., & Chen, C. H. (2004). Patient with Small Cell Lung Carcinoma-Induced Acute Pancreatitis: A Case Report. 胸腔醫學, 19(6), 498-502. https://doi.org/10.29806/TM.200412.0010