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恶性无功能性胰岛细胞瘤比较少见,术前常常误诊,术后病检也不易确诊。我院收治1例,现报告如下: 患者,女,50岁,主因上腹部不适伴恶心4个月,上腹部肿物渐大2个月入院。查体:消瘦,皮肤粘摸无黄染,腹呈舟状,剑突下可触及一6×8cm的肿物,质硬,表面欠光滑,肝脏肿大,脾脏未及。化验:血糖75mg％,尿糖(-),血淀粉酶16单位,尿淀粉酶32单位。上消化道造影:胃小弯受压,疑为胰尾部肿物。B超提示胰尾部肿物。经皮肿物穿刺涂片,只见腺细胞,未见恶性瘤细胞。术前诊断胰腺癌。
Malignant and nonfunctioning islet cell tumors are rare and often misdiagnosed before surgery. Postoperative pathology is not easily diagnosed. In our hospital, 1 case was reported as follows: Patients, women, 50 years old, mainly due to epigastric discomfort with nausea for 4 months, upper abdominal mass gradually admitted to hospital for 2 months. Physical examination: weight loss, no yellow dyeing on the skin, and a boat-shaped abdomen. A 6×8 cm tumor can be touched under the xiphoid process. The surface is hard, the surface is less smooth, the liver is swollen, and the spleen is not. Laboratory tests: Blood glucose 75 mg%, urine glucose (-), blood amylase 16 units, urine amylase 32 units. Upper gastrointestinal angiography: Stomach curvature is under pressure and a pancreatic tail mass is suspected. B-tip pancreatic tail tumor. Puncture smears of percutaneous tumors showed only glandular cells and no malignant tumor cells. Preoperative diagnosis of pancreatic cancer.