合併實心與囊狀的胰臟腫瘤－－2病例報告

Solid-cystic Tumor of the Pancreas: Report of 2 Cases

胰臟合併實心與囊狀腫瘤好發於年輕女性，為罕見的低惡性腫瘤。雖然局部侵犯及包膜浸潤可見，卻少有遠處轉移。此腫瘤預後佳，巨大的腫瘤為發現之特徵，手術切除為根本的治療方法。病理診斷易與非功能性胰島細胞腫瘤、囊腺瘤及囊腺癌產生混淆。我們報告2病例，著重於放射影像及病理特徵的描述；此腫瘤包含乳突，但不形成樑狀和微腺胞。其細胞經常繞著小微血管排列成類玫瑰狀，電腦斷層顯示此胰臟腫瘤可能是實心的、囊狀的、或二者兼具：其中1例有週邊鈣化。組織學上，腫瘤有乳突狀表徵，並有出血及壞死區域，術前的正確診斷對預後的幫助很大。

The solid-cystic tumor of the pancreas is an uncommon, low-grade malignant tumor occurring exclusively in young women. It is known to have a good prognosis, though local invasion and infiltration of the pancreatic capsule may occur and distant metastasis is uncommon. The tumor is usually large at the time of presentation, and surgical excision is the treatment of choice. Pathological misdiagnosis as nonfunctional islet cell tumor, cystadenoma, or cystadenocarcinoma is fairly common. We report 2 cases of such a tumor, focusing on the radiologic findings with the pathologic correlation. Pathologically the tumor cells were arranged around tiny vessels as pseudorosettes formation. By computed tomography the tumor depicted a well demarcated mass, mixed cystic and solid or largely cystic. For 1 of them, the tumor contained rim calcification. The preoperative correct diagnosis of such tumors is important because the prognosis after complete resection is good.