李阳光 吴帆 赵陇成 胡悦

【摘要】胰腺神经鞘瘤是一种极为罕见的神经源性肿瘤，缺乏特征性临床表现和影像学征象，术前明确诊断存在较大困难，常与其他胰腺良恶性肿瘤难以鉴别。文章报道1例胰腺体部神经鞘瘤患者的诊治经过，患者为44岁女性，因体检发现胰腺肿物5 d入院，行腹部增强CT提示胰腺体部肿物，约6.4 cm×5.4 cm，予行胰腺中段切除+远端胰腺残端空肠Roux-en-Y吻合术，术后病理回报符合胰腺上皮样神经鞘瘤。术后随访2年余，未见肿瘤复发或转移。该例为临床医师诊治胰腺神经鞘瘤提供了临床参考。

【关键词】胰腺肿瘤；神经鞘瘤；外科手术；病理诊断

Schwannoma of the pancreatic body： a case report

LI Yangguang1， WU Fan1 ， ZHAO Longcheng1， HU Yue2

（1.Department of Hepatobiliary Pancreatic Thyroid Surgery， Guangzhou Red Cross Hospital Affiliated to Jinan University， Guangzhou 510220， China； 2.Department of Pathology， Guangzhou Red Cross Hospital Affiliated to Jinan University， Guangzhou 510220， China）

Corresponding author： WU Fan， E-mail： wufan7911@163.com

【Abstract】Pancreatic schwannoma is an extremely rare neurogenic tumor， lacking of specific clinical manifestations and imaging signs. It is difficult to make a definite diagnosis before operation， and it is frequently misdiagnosed with other benign and malignant tumors of the pancreas. In this article， the diagnosis and treatment of a patient with pancreatic schwannoma were reported. The 44-year-old female patient was admitted to the hospital because of pancreatic mass found by physical examination for 5 days. Abdominal enhanced CT scan showed pancreatic body mass， approximately 6.4 cm×5.4 cm in size. The patient underwent middle pancreatectomy and distal pancreatic stump jejunum Roux-en-Y anastomosis. Postoperative pathological report was consistent with pancreatic epithelioid schwannoma. During the follow-up of 2 years， no tumor recurrence or metastasis was found. This case provides clinical reference for clinicians to diagnose and treat pancreatic schwannoma.

【Key words】Pancreatic neoplasms； Schwannoma； Surgery； Pathologic diagnosis

胰腺神經鞘瘤是来源于胰腺周围神经鞘膜施万细胞的肿瘤，在临床上极为罕见。胰腺神经鞘瘤的术前诊断极为困难，根据症状、体征和影像很难确诊［1］。本文报道1例我院收治的胰腺体部神经鞘瘤患者的诊疗过程并文献复习，旨在提高临床医师对这种罕见疾病的认识水平以指导其诊断和治疗。

1 病例资料

1.1 主诉及病史及体格检查

患者女，44岁。因“出现上腹部不适，体检发现胰腺肿物5 d”于2021年10月8日入院。患者半年前无明显诱因出现上腹部不适，未行检查及治疗；5 d前于当地医院体检发现胰腺肿物，大小约6 cm×7 cm，后转入我院治疗。患者有2型糖尿病及子宫肌瘤病史，否认家族遗传性疾病史。查体：无黄疸，腹部平坦，上腹深部可触及一大小约7 cm×7 cm的肿物，质韧，活动度差，无压痛、反跳痛，移动性浊音阴性。

1.2 实验室及辅助检查

实验室检查示血常规、肝功能无明显异常。……