目的 探讨胰腺实性假乳头状瘤(SPT)的临床病理特点、影像学特点,总结诊疗经验.方法 对2008年9月至2012年9月我院单中心收治的27例SPT患者的临床资料进行回顾性分析.结果 全部27例患者行手术切除,行胰十二指肠切除4例,保留十二指肠胰头肿瘤切除6例,胰腺中段切除5例,保留脾脏胰体尾切除5例,胰体尾+脾切除7例.27例患者中有12例合并不同程度的胰漏及发热,其中有1例术后出现脾动脉出血.全部患者随访中有1例术后2年出现复发并再次手术切除,余均未出现复发及转移,无死亡.结论 胰腺SPT常见于青年女性,为交界性恶性潜能肿瘤,预后好.CT及MRI是最主要的影像学检查方法.治疗原则建议行根治性手术切除,同时争取保留周边脏器结构功能完整.%Objective To summarize the clinicopathologic features and treatment outcomes of solid pseudopapillary tumors ( SPTs) of the pancreas, lyiethods Twenty-seven cases of SPT of the pancreas admitted for treatment to the Peking University Cancer Hospital between September 2008 and September 2012 were retrospectively analyzed. Results The majority of the pancreatic SPT patients were young adults ( median age: 29 years old) and females ( 85. 2% ). All 27 patients were treated with surgical resection using pancreaticoduodenectomy ( n = 4 ) , duodenum preserving pancreatic tumor resection ( n = 6 ) , middle pancreatectomy ( n = 5 ) , distal pancreatectomy ( n = 5 ) , or distal pancreatectomy plus splenectomy ( n = 7). The minimum tumor diameter was 1.5 cm, the maximum diameter was 12.0 cm, and the average diameter was 5.4 cm. Twelve patients developed pancreatic leakage and pyrexia following the operation. One patient suffered splenic artery hemorrhage. All 27 patients survived and completed follow-up. Only one patient developed recurrence, which was treated by a second surgical resection, and all other patients showed no clinical signs of recurrence or metastasis. Conclusion SPT of the pancreas has uncertain malignant potential with good prognosis. Radical resection with preservation of the surrounding tissues is an effective and safe treatment for SPT.
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