| 摘要 |
Solid and papillary epithelial neoplasm of the pancreas is a rare pancreatic tumor, and it occurs most in young females and adolescents. Generally it behaves either as a benign or low grade maligant neoplasm and its nature indicates a favorable prognosis. We present a rare advanced case. A 20-year-old woman initially presented with progressive jaundice, anorexia, poor intake, and post-prandial vomiting two weeks prior to admission. Two ill-defined masses were palpable over the left upper abdomen and right iliac fossa on physical examination. Anemia and jaundice were also noted. Abdominal computed tomography showed multiple masses at the Douglas pouch, supra-urinary bladder, mesentery, omentum and lesser sac. Percutaneous transhepatic cholangiography demonstrated termination at the common hepatic duct and endoscopic retrograde pancreatography revealed abrupt disruption of the pancreatic duct at the pancreatic head. Laparoscopy was performed and two masses of 1cm in size were sent for pathologic examination. Histopathologic examination showed proliferation of solid sheets of monotonous cells arranged in a pseudopapillary pattern. The tumor was identified as a solid-performed and two masses of 1cm in size were sent solid sheets of monotonous cells arranged in a pseudopapillary pattern. The tumor was identified as a solid-pseudopapillary tumor of the pancreas. The patient was treated with chemotherapy but the tumor mass enlarged progressively, which was identified in the follow-up abdominal computed tomography. She strted to take chinese herb for treatment and was regularly followed up at our clinics for nealy one year. Rare cases present with advanced disease initially as in our patient. It is important to recognize such an unusual presentation may occur in patients with solid and papillary epithelial neoplasms of the pancreas. |
