妊娠中の膵臓の大型粘液性嚢胞性新生物：症例報告

Large mucinous cystic neoplasm of the pancreas during pregnancy: a case report.

• Lúcia Carvalho
• Tiago Ferreira
• Luísa Frutuoso
• Leonor Matos
• Tiago Castro
• Domingos Rodrigues
• Vera Oliveira
• Gil Gonçalves
• Mário Nora
• Horácio Scigliano

抄録

妊娠中に発生する膵臓の粘液性嚢胞性新生物（MCN）は、大きさが大きく、悪性度が高く、胎児の発育制限のリスクがあるため、特別な管理が必要な稀な疾患である。MCNの管理のポイントは、正しい診断を行い、悪性度を正確に評価して膵臓手術の適切な時期を見極め、最も適切な胎児分娩法を選択することである。第3期妊婦で発見された偶発的な腹部腫瘤の1例を紹介する。手術では巨大な膵嚢胞性腫瘍が見つかり，脾臓温存下で遠位膵切除術を施行した．病理組織学的解析の結果、低悪性度の異形成を伴う膵臓のMCNが明らかになった。我々の知る限りでは、これは文献に報告されている妊婦で検出された最大の膵臓MCNであり、経腟分娩後に切除に成功した数少ない膵臓の一つである。

Mucinous cystic neoplasms (MCNs) of the pancreas occurring during pregnancy constitute a rare condition requiring special management due to its large size, malignant potential and the risk of fetal growth restriction. The key points to manage MCNs are to perform a correct diagnosis, accurately evaluate the grade of malignant potential in order to establish the right time for pancreatic surgery and to choose the most appropriate fetal mode of delivery. We describe a case of an incidental abdominal mass detected in a third-trimester pregnant woman. At surgery, a huge pancreatic cystic tumour was found and a distal pancreatectomy with splenic preservation was performed. The histopathological analysis revealed an MCN of the pancreas with low-grade dysplasia. To our knowledge, this is the largest pancreatic MCN detected in a pregnant woman reported in the literature and one of the few successfully resected after vaginal delivery.

Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2020.