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病人女性,41岁。以主诉“胰尾+脾切除术后6年,左腰背部隐痛不适1个月余”于2010-07-28入院。6年前在当地医院检查发现胰尾占位,行胰尾+脾切除术。术后病理报告:胰腺囊实性乳头上皮性肿瘤。近1个月以来出现左腰背部不适,强化CT及MRI检查发现左侧肾上腺区、胃大弯侧两处占位,考虑胰腺术后肿瘤复发转移可能性大。消化系统B超提示肾上极肾周可探及3.9cm×4.3cm低回声区,边界尚清。入院检查:肿瘤标记物癌胚抗原(CEA)、CA19-9在正常范围,其他血生化检查无异常。术前诊断为:(1)腹腔占位,性质待查。于2010-07-30全麻下行剖腹探查术。术中见左侧肾上极与胃大弯侧大网膜内分别可
Female patient, 41 years old. To complain “pancreatic tail + splenectomy after 6 years, left lower back pain discomfort more than 1 month ” admitted in 2010-07-28. 6 years ago in the local hospital examination found tail-side pancreas, pancreatic tail + splenectomy. Postoperative pathology report: pancreatic cystic solid papillary epithelial tumor. Left lower back discomfort occurred in nearly 1 month. CT and MRI examination showed that the left adrenal area and the gastric curvature side were two places, considering the possibility of tumor recurrence and metastasis after the operation of pancreas. Digestive system B-prompt renal renal pole probing and 3.9cm × 4.3cm hypoechoic area, the boundary is still clear. Admission examination: tumor markers carcinoembryonic antigen (CEA), CA19-9 in the normal range, no abnormalities in other blood biochemical tests. Preoperative diagnosis: (1) abdominal mass, nature to be investigated. Underwent laparotomy in 2010-07-30 under general anesthesia. Intraoperative see the left renal pole and stomach big curved side of the omentum can be