5例胰腺韧带样瘤的临床诊治分析
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摘要
目的:总结胰腺韧带样瘤的临床特点及其诊断、治疗、预后。方法:回顾性分析我院2009年1月至2017年1月5例胰腺韧带样瘤患者的临床资料,研究其诊治特点和效果。结果:5例患者都进行手术治疗,所有手术均顺利完成,其中行胰十二指肠切除术3例,胰体尾脾切除术2例,术后出现胰瘘患者2例,随访时间内,失访1人,随访4人,无复发无转移及死亡病例。结论:胰腺韧带样瘤是一种罕见的纤维组织肿瘤,低度恶性,局部侵袭易复发,无转移,手术切除为首选治疗方法,术后辅以放疗可降低复发几率,术后需密切随访。
Objective:To summarize the clinical characteristics of pancreatic desmoids tumor and its diagnosis,treatment and prognosis.Methods:The clinical database of 5 patients with pancreatic desmoid tumor from January 2009 to January 2017 were retrospectively analyzed,and the diagnosis and treatment characteristics and effects were studied.Results:All the patients underwent surgical treatment.three patients underwent pancreaticoduodenectomy and two patients underwent distai pancreatectomy with spleenectomy procedure.There were 2 patients with pancreatic fistula after the operation.There was no recurrence,no metastasis and death cases.Conclusion:Pancreatic desmoid tumor is a rare fibrous tissue tumor,low degree of malignant,local invasion,easily to relapse,no metastasis,surgical resection for the preferred treatment.Radiotherapy can reduce the risk of recurrence,with postoperative follow-up.
Objective:To summarize the clinical characteristics of pancreatic desmoids tumor and its diagnosis,treatment and prognosis.Methods:The clinical database of 5 patients with pancreatic desmoid tumor from January 2009 to January 2017 were retrospectively analyzed,and the diagnosis and treatment characteristics and effects were studied.Results:All the patients underwent surgical treatment.three patients underwent pancreaticoduodenectomy and two patients underwent distai pancreatectomy with spleenectomy procedure.There were 2 patients with pancreatic fistula after the operation.There was no recurrence,no metastasis and death cases.Conclusion:Pancreatic desmoid tumor is a rare fibrous tissue tumor,low degree of malignant,local invasion,easily to relapse,no metastasis,surgical resection for the preferred treatment.Radiotherapy can reduce the risk of recurrence,with postoperative follow-up.
引文
[1] Polistina F,Costantin G,D'Amore E,et al.Sporadic,nontrauma-related,desmoid tumor of the pancreas:A rare disease-case report and literature review[J].Case Rep Med,2010,2010:272760.
[2] Ma Dongjie,Zhang Zhiyong,Li Danqing,et al.Advances in diagnosis and treatment of aggressive fibromatosis[J].Beijing Medical Journal,2015,37(3):272-275.[马东捷,张志庸,李单青.侵袭性纤维瘤病的诊治进展[J].北京医学,2015,37(3):272-275.]
[3] Sakorafas GH,Nissotakis C,Peros G,et al.Abdominal desmoid tumors[J].Surg Oncol,2007,16:131-142.
[4] Pho LN,Coffin CM,Burt RW,et al.Abdominal desmoid in familial adenomatous polyposis presenting as a pancreatic cystic lesion[J].Fam Cancer,2005,4:135-138.
[5] Liegl B,Leithner A,Bauernhofer T,et al.Immunohistochemical and mutational analysis of PDGF and PDGFR in desmoid tumours:Is there a role for tyrosine kinase inhibitors in c-kit-negative desmoid tumours[J]?Histopathology,2006,49:576-581.
[6] Harsh D Patel,NeilR Desai,Aniruddh Som,et al.Solid-cystic pancreatic tail desmoid tumor with beta-catenin positivity[J].ACG Case Reports Journal,2017,4:1-2.
[7] Zhai Songtang,Zhai Tao,Qiao Guoxia,et al.Diagnosis and treatment of desmoid tumors in 24 cases[J].Henan Journal of Surgery,2006,12(2):42.[翟松堂,翟涛,乔国霞.24例硬纤维瘤的诊断与治疗[J].河南外科学杂志,2006,12(2):42.]
[8] H Saleh,R Kapadia.Aspiration biopsy cytology of extraabdominal desmoid tumor concurrently occurring in a patient with tumoral calcinosis[J].Diagnostic Cytopathology,2008,36(9):624-627.
[9] Yuan Lili,Xu Chuanjun.Clinical and pathological analysis of desmoid tumor[J].Journal of Medical Imaging,2015,25(12):2229-2233.[袁莉莉,许传军.韧带样瘤的影响表现与病理分析[J].医学影像学杂志,2015,25(12):2229-2233.]
[10] Bertani E,Testori A,Chiappa A,et al.Recurrence and prognostic factors in patients with aggressive fibromatosis.The role of radical surgery and its limitations[J].World J Surg Oncol,2012,10:184.
[11] Lev D,Kotilingan D,Wei C,et al.Optimizing treatment of desmoids tumors[J].J Clin Oncol,2007,25:1785-1791.
[12] Deyrup AT,Tretiakova M,Montag AG,Estrogen receptor-beta expression in extraabdominal fibromatoses:An analysis of 40 cases[J].Cancer,2006,106(1):208-213.
[13] Hamada S,Urakawa H,Kozawa E,et al.Nuclear expression of β-catenin predicts the efficacy of meloxicam treatment for patients with sporadic desmoid tumors [J].Tumour Biol,2014,35:4561-4566.
[14] Wang Yuchieh,Wong Jiauei.Complete remission of pancreatic head desmoids tumor treated by COX-2 inhibitor-a case report[J].World Journal of Surgical Oncology,2016,14:190.
[15] Jan Kriza,Hans Theodor Eich.Radiotherapy is effective for desmoid tumors (aggressive fibromatosis)-long-term results of a German multicenter study[J].Oncol Res Treat,2014,37:255-260.
[16] S Otero,EC Moskoovic,DC Strauss,et al.Desmoid-type fibromatosis[J].Clinical Radiology,2015,70(9):1038-1045.
[2] Ma Dongjie,Zhang Zhiyong,Li Danqing,et al.Advances in diagnosis and treatment of aggressive fibromatosis[J].Beijing Medical Journal,2015,37(3):272-275.[马东捷,张志庸,李单青.侵袭性纤维瘤病的诊治进展[J].北京医学,2015,37(3):272-275.]
[3] Sakorafas GH,Nissotakis C,Peros G,et al.Abdominal desmoid tumors[J].Surg Oncol,2007,16:131-142.
[4] Pho LN,Coffin CM,Burt RW,et al.Abdominal desmoid in familial adenomatous polyposis presenting as a pancreatic cystic lesion[J].Fam Cancer,2005,4:135-138.
[5] Liegl B,Leithner A,Bauernhofer T,et al.Immunohistochemical and mutational analysis of PDGF and PDGFR in desmoid tumours:Is there a role for tyrosine kinase inhibitors in c-kit-negative desmoid tumours[J]?Histopathology,2006,49:576-581.
[6] Harsh D Patel,NeilR Desai,Aniruddh Som,et al.Solid-cystic pancreatic tail desmoid tumor with beta-catenin positivity[J].ACG Case Reports Journal,2017,4:1-2.
[7] Zhai Songtang,Zhai Tao,Qiao Guoxia,et al.Diagnosis and treatment of desmoid tumors in 24 cases[J].Henan Journal of Surgery,2006,12(2):42.[翟松堂,翟涛,乔国霞.24例硬纤维瘤的诊断与治疗[J].河南外科学杂志,2006,12(2):42.]
[8] H Saleh,R Kapadia.Aspiration biopsy cytology of extraabdominal desmoid tumor concurrently occurring in a patient with tumoral calcinosis[J].Diagnostic Cytopathology,2008,36(9):624-627.
[9] Yuan Lili,Xu Chuanjun.Clinical and pathological analysis of desmoid tumor[J].Journal of Medical Imaging,2015,25(12):2229-2233.[袁莉莉,许传军.韧带样瘤的影响表现与病理分析[J].医学影像学杂志,2015,25(12):2229-2233.]
[10] Bertani E,Testori A,Chiappa A,et al.Recurrence and prognostic factors in patients with aggressive fibromatosis.The role of radical surgery and its limitations[J].World J Surg Oncol,2012,10:184.
[11] Lev D,Kotilingan D,Wei C,et al.Optimizing treatment of desmoids tumors[J].J Clin Oncol,2007,25:1785-1791.
[12] Deyrup AT,Tretiakova M,Montag AG,Estrogen receptor-beta expression in extraabdominal fibromatoses:An analysis of 40 cases[J].Cancer,2006,106(1):208-213.
[13] Hamada S,Urakawa H,Kozawa E,et al.Nuclear expression of β-catenin predicts the efficacy of meloxicam treatment for patients with sporadic desmoid tumors [J].Tumour Biol,2014,35:4561-4566.
[14] Wang Yuchieh,Wong Jiauei.Complete remission of pancreatic head desmoids tumor treated by COX-2 inhibitor-a case report[J].World Journal of Surgical Oncology,2016,14:190.
[15] Jan Kriza,Hans Theodor Eich.Radiotherapy is effective for desmoid tumors (aggressive fibromatosis)-long-term results of a German multicenter study[J].Oncol Res Treat,2014,37:255-260.
[16] S Otero,EC Moskoovic,DC Strauss,et al.Desmoid-type fibromatosis[J].Clinical Radiology,2015,70(9):1038-1045.