腹腔鏡下核出術にて切除しえた膵頭部solid pseudopapillary tumorの1例

Solid pseudopapillary tumor of the pancreas treated by laparoscopic enucleation

◆要旨：患者は54歳，女性．近医にて膵頭部腫瘍を指摘され，精査加療目的にて当科に入院した．US・CT・MRI検査から膵頭部のsolid pseudopapillary tumor（以下，SPT）が疑われた．手術は膵機能温存と手術侵襲を考慮し，腹腔鏡下膵腫瘍核出術を施行した．術中所見では腫瘍は膵頭部に半球状に存在しており，膵組織との境界は明瞭であった．術中迅速病理検査にてSPTと診断した．術後経過は順調で，膵機能も温存され，術後第8病日に退院した．SPTは若年女性に好発し，多くは予後良好な腫瘍である．SPTに対する腹腔鏡下腫瘍核出術は低侵襲であり，膵機能温存という点においても有用であり，考慮すべき術式と考えられた．

　A 54-year-old woman was referred to our hospital due to a pancreatic head tumor diagnosed at a nearby hospital. Ultrasonography（US）, computed tomography（CT）and magnetic resonance imaging（MRI）showed a pancreatic mass. A solid pseudopapillary tumor（SPT）of the pancreatic head was diagnosed and the tumor was treated by laparoscopic enucleation. Intraoperative findings showed the tumor with a clear boundary and hemispherical protrusion that measured approximately 3 cm in diameter in the pancreatic head. Histopathological examination confirmed the tumor to be SPT. The postoperative course was favorable, and there was no complications and impairment of pancreatic function. The patient was discharged on 8 postoperative day. SPT is a common disease, usually benign, in young women. Laparoscopic enucleation is a minimally invasive and effective treatment that does not inhibit the pancreatic function.