Pancreatoblastoma of the pancreatic head with portal tumor embolism in a 2-year-old boy
Pancreatoblastoma of the pancreatic head with portal tumor embolism in a 2-year-old boy
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2岁男童胰头胰母细胞瘤合并门脉瘤栓塞
DOI：
10.1016/j.epsc.2022.102261
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发表时间：
2022
影响因子：
0.4
通讯作者：
Araki Raita
中科院分区：
文献类型：
--
作者：
Sakai Seisho;Tajima Hidehiro;Nomura Kozo;Hayashi Kentaro;Mizushima Honami;Abe Takatoshi;Noguchi Kazuhiro;Fujiki Toshihiro;Kuroda Rie;Ikawa Yasuhiro;Araki Raita
一名2岁男童因粪便呈灰白色白色而就诊。经检查发现胰腺肿瘤。肿瘤位于胰头，胆总管被肿瘤和周围淋巴结完全闭塞。观察到门静脉中的肿瘤栓塞。在门静脉中观察到与肿瘤栓塞相关的副血液循环的发展。进行肿瘤活检和胆道引流管放置。肿瘤被诊断为胰腺母细胞瘤。化疗3个疗程后行保留幽门的胰腺癌切除术。对于门静脉瘤栓，打开门静脉，并尽可能多地切除瘤栓。采用胰管插入法进行胰腺和小肠吻合，使胰液完全排出体外。术后怀疑门静脉内有小肿瘤残留。术后行大剂量化疗、外周血干细胞移植和质子束治疗作为补充治疗。目前，患者已存活7年，无复发。
A 2-year-old boy visited the hospital with a complaint of grayish white stool. A pancreatic tumor was found on investigation. The tumor was located at the head of the pancreas, and the common bile duct was completely occluded by the tumor and surrounding lymph nodes. A tumor embolism in the portal vein was observed. Development of accessory blood circulation associated with tumor embolization in the portal vein was observed. Tumor biopsy and biliary drainage tube placement were performed. The tumor was diagnosed as pancreatoblastoma. Pylorus-preserving pancreaticoduodenectomy was performed after three courses of chemotherapy. For the portal vein tumor plug, the portal vein was opened, and as much of the tumor plug was removed as possible. Anastomosis of the pancreas and small intestine was performed using the pancreatic duct insertion method, and the pancreatic juice was completely discharged from the body. After the operation, it was suspected that there was a small tumor remnant in the portal vein. Postoperative high-dose chemotherapy with peripheral blood stem cell transplantation and proton beam therapy were performed as additional treatments. Currently, the patient has been alive for 7 years without recurrence.