Enteric duplication cyst

  • 文章类型: Review
    背景。肠重复囊肿很少见,但可发生在胃肠道的各个部位,包括胰腺.大多数肠重复囊肿是良性的;然而,已经报道了少数病例的肿瘤转化,腺癌是最常见的恶性转化。案例介绍。我们介绍了一名患有胰腺肠重复囊肿和低度粘液性肿瘤的成年人。患者没有表现出任何临床上显著的症状或体征。影像学显示胰头囊性肿块。经过病理检查,发现囊肿具有双层肌肉壁,内表面衬有假分层的粘液性柱状上皮。高倍显微镜显示上皮细胞低度发育不良。最终的病理诊断证实肠重复囊肿伴有低度粘液性肿瘤。结论。据我们所知,这是第一例报道的发生在胰腺肠重复囊肿中的低度粘液性肿瘤。强调完全手术切除和充分病理采样的重要性,以避免在这些重复囊肿中漏检出发育异常或恶性肿瘤。
    Background. Enteric duplication cysts are rare but can occur in various parts of the gastrointestinal tract, including the pancreas. Most enteric duplication cysts are benign; however, neoplastic transformation has been reported in a few cases, with adenocarcinoma being the most common malignant transformation. Case Presentation. We present an adult with a pancreatic enteric duplication cyst and low-grade mucinous neoplasm. The patient did not exhibit any clinically significant symptoms or physical signs. Imaging revealed a cystic mass in the pancreatic head. Upon pathological examination, the cyst was found to have a bilayered muscular wall with an inner surface lined with pseudostratified mucinous columnar epitheliums. High-power microscopy revealed low-grade dysplasia in epithelial cells. The final pathological diagnosis confirmed an enteric duplication cyst with a low-grade mucinous neoplasm. Conclusion. To the best of our knowledge, this is the first reported case of a low-grade mucinous neoplasm occurring in an enteric duplication cyst in the pancreas. The importance of complete surgical resection and adequate pathological sampling is emphasized to avoid the missed detection of dysplasia or malignancy in these duplication cysts.
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    文章类型: Case Reports
    BACKGROUND: Enteric duplication cysts are rare congenital anomalies. They are lined by gastrointestinal mucosa, connected to the digestive tract, and share smooth muscle layers and a common blood supply. In rare cases, duplication cysts are isolated from the digestive tract and have a unique blood supply. No patient with isolated duplication cysts that are located in the retroperitoneum and associated with an accessory pancreatic lobe at the onset have been reported to date.
    METHODS: A 10-year-old Asian boy complained of left upper abdominal pain for more than 3 months. Contrast-enhanced computed tomography showed that the main pancreatic duct in the tail of the pancreas was dilated. A soft tissue density shadow was observed around the tail of the pancreas. The lesion was connected to the main pancreatic duct and the blood was supplied from a branch of the splenic artery. Surgical exploration and pathologic specimens resulted in the diagnosis of an isolated retroperitoneal enteric duplication cyst associated with an accessory pancreatic lobe. The patient received treatments of rehydration, antibiotics, and protease inhibitors. Due to the poor conservative treatment effect in internal medicine, a surgical resection of abnormal tissue was performed.
    RESULTS: The boy did not have abdominal pain again in the first year after leaving the hospital.
    CONCLUSIONS: For repeated abdominal pain in young people, especially in children, an enteric duplication cyst needs to be ruled out. This case was difficult to diagnose and imaging examination was not able to determine whether it is located in the anterior peritoneum or the retroperitoneum. For such cases, surgical exploration is necessary, and surgical resection can achieve more satisfactory results.
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