リンパ節転移を伴った比較的小さな膵Solid-Pseudopapillary tumorの1例

症例は27才,女性.心窩部痛を訴え当院を受診,尿中アミラーゼの軽度上昇を認めたため急性膵炎の診断で入院した.入院後,腹部超音波,CT,MRI検査を施行し膵体尾部に石灰化を伴う嚢胞性腫瘤を認め,その尾側膵管に拡張を認めた.嚢胞性膵臓腫と診断し,膵体尾部および脾合併切除を施行した.その結果,心窩部痛は消失した.腫瘤は肉眼的に3.2×2.2×2.0cmの嚢胞性部分と充実性部分の混在する腫瘍で病理学的に膵solid-pseudopapillary tumorと診断した.本腫瘍は低悪性度の膵腫瘍とされているが本例はリンパ節転移を認め意義ある1例と考えられ報告する.A 27-year-old woman visited our hospital, because she bad experienced severe epigastric pain. The diagnosis on admission was acute pancreatitis, which was determined by elevation of urinary amylase. A hyperechoic tumor was detected in the pancreatic body-tail position ultra-sonographically. CT and MRI detected the tumor as a cystic tumor, and also disclosed dilatation of the distal pancreatic duct. Therefore, a distal pancreatectomy and a splenectomy were performed. The lesion was pathologically diagnosed as a solid-pseudopapillary tumor of the pancreas. It is very rare of this type of tumor to have malignant potential, but, in this case, the tumor was complicated by lymph node metastasis