pirogovestnikВестник Национального медико-хирургического центра им. Н.И. ПироговаBulletin of Pirogov National Medical & Surgical Center2072-82552782-3628Национальный медико-хирургический Центр им. Н.И. Пирогова10.25881/20728255_2025_20_4_152pirogovestnik-491Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCASE REPORTSМАЛИГНИЗИРОВАННАЯ КИСТОЗНАЯ ОПУХОЛЬ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ В МОЛОДОМ ВОЗРАСТЕMALIGNANT CYSTIC TUMOR OF THE PANCREAS AT A YOUNG AGEЕгоровВ. И.EgorovV. I.

Казань

Kazan

drvasiliy21@gmail.comУсачевА. В.UsachevA. V.

Казань

Kazan

ШарафутдиноваР. Р.SharafutdinovaR. R.

Казань

Kazan

ФГБОУ ВО «Казанский государственный медицинский университет»; ГАУЗ «Республиканский клинический онкологический диспансер»РоссияKazan State Medical University; Republican Clinical Oncology DispensaryRussian FederationФГБОУ ВО «Казанский государственный медицинский университет»РоссияKazan State Medical UniversityRussian FederationГАУЗ «Республиканский клинический онкологический диспансер»РоссияRepublican Clinical Oncology DispensaryRussian Federation202505122025204152154Copyright © Егоров В.И., Усачев А.В., Шарафутдинова Р.Р., 20252025Егоров В.И., Усачев А.В., Шарафутдинова Р.Р.Egorov V.I., Usachev A.V., Sharafutdinova R.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://submit.pirogov-vestnik.ru/jour/article/view/491

Представлено клиническое наблюдение лечения пациентки 22 лет с малигнизированной кистозной опухолью поджелудочной железы. При первичном обращении в виду возраста, отсутствия онкологического анамнеза, небольшого размера новообразования, отсутствия ракового роста по данным биопсии, отсутствия клинических проявлений было рекомендовано динамическое наблюдение. В динамике через 6 месяцев выявлено увеличение размеров опухоли поджелудочной железы. После комплексного дообследования были выставлены показания к операции и проведена лапароскопическая спленосохранная дистальная резекция поджелудочной железы по типу Warshaw. Послеоперационное патогистологическое исследование: муцинозная кистозная опухоль поджелудочной железы с микрофокусами high grade дисплазии эпителия (Сa in situ). Сделан вывод о том, что онконастороженный подход при кистозных опухолях поджелудочной железы должен быть в том числе у лиц молодого возраста.

This paper presents a clinical case of treating a 22-year-old female patient with a malignant cystic tumor of the pancreas. At the initial consultation, due to her age, no oncological history, small size of the tumor, no cancerous growth according to biopsy data, and no clinical manifestations, dynamic observation was recommended. In dynamics, after 6 months, an increase in the size of the pancreatic tumor was detected. After a comprehensive additional examination, indications for surgery were established and laparoscopic spleen-preserving distal resection of the pancreas according to the Warshaw type was performed. Postoperative pathohistological examination: mucinous cystic tumor of the pancreas with high-grade microfoci of epithelial dysplasia (Ca in situ). It is concluded that an  oncoguarded approach to cystic tumors of the pancreas should be used,  including in young people.

кистозная опухоль поджелудочной железырак поджелудочной железыдистальная резекция поджелудочной железыкистозный ракмалигнизацияcystic tumor of the pancreaspancreatic cancerdistal resection of the pancreas Warshawcystic cancermalignancyReferencesZerboni G, Signoretti M, Crippa S, Falconi M, Arcidiacono PG, Capurso G. Systematic review and meta-analysis: Prevalence of incidentally detected pancreatic cystic lesions in asymptomatic individuals. Pancreatology. 2019; 19(1): 2-9. doi: 10.1016/j.pan.2018.11.014.Zerboni G, Signoretti M, Crippa S, Falconi M, Arcidiacono PG, Capurso G. Systematic review and meta-analysis: Prevalence of incidentally detected pancreatic cystic lesions in asymptomatic individuals. Pancreatology. 2019; 19(1): 2-9. doi: 10.1016/j.pan.2018.11.014.Laffan TA, Horton KM, Klein AP, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol. 2008; 191(3): 802-7. doi: 10.2214/AJR.07.3340.Laffan TA, Horton KM, Klein AP, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol. 2008; 191(3): 802-7. doi: 10.2214/AJR.07.3340.Chang YR, Park JK, Jang JY, Kwon W, Yoon JH, Kim SW. Incidental pancreatic cystic neoplasms in an asymptomatic healthy population of 21,7-45 individuals: Large-scale, single-center cohort study. Medicine (Baltimore). 2016; 95(51): e5535. doi: 10.1097/MD.0000000000005535.Chang YR, Park JK, Jang JY, Kwon W, Yoon JH, Kim SW. Incidental pancreatic cystic neoplasms in an asymptomatic healthy population of 21,7-45 individuals: Large-scale, single-center cohort study. Medicine (Baltimore). 2016; 95(51): e5535. doi: 10.1097/MD.0000000000005535.The World Gastroenterology Organisation. Global practice recommendations for pancreatic cysts. Available from: https://www.worldgastroenterology.org/guidelines/pancreatic-cysticlesions/pancreatic-cystic-lesions-russian.The World Gastroenterology Organisation. Global practice recommendations for pancreatic cysts. Available from: https://www.worldgastroenterology.org/guidelines/pancreatic-cysticlesions/pancreatic-cystic-lesions-russian.Ardeshna DR, Cao T, Rodgers B, Onongaya C, et al. Recent advances in the diagnostic evaluation of pancreatic cystic lesions. World J Gastroenterol. 2022; 28(6): 624-634. doi: 10.3748/wjg.v28.i6.624.Ardeshna DR, Cao T, Rodgers B, Onongaya C, et al. Recent advances in the diagnostic evaluation of pancreatic cystic lesions. World J Gastroenterol. 2022; 28(6): 624-634. doi: 10.3748/wjg.v28.i6.624.European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut. 2018; 67(5): 789-804. doi: 10.1136/gutjnl-2018-316027.European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut. 2018; 67(5): 789-804. doi: 10.1136/gutjnl-2018-316027.Okasha HH, Awad A, El-Meligui A, Ezzat R, et al. Cystic pancreatic lesions, the endless dilemma. World J Gastroenterol. 2021; 27(21): 2664-2680. doi: 10.3748/wjg.v27.i21.2664.Okasha HH, Awad A, El-Meligui A, Ezzat R, et al. Cystic pancreatic lesions, the endless dilemma. World J Gastroenterol. 2021; 27(21): 2664-2680. doi: 10.3748/wjg.v27.i21.2664.Miller KD, Fidler-Benaoudia M, Keegan TH, Hipp HS, Jemal A, Siegel RL. Cancer statistics for adolescents and young adults, 2020. CA Cancer J Clin. 2020; 70(6): 443-459. doi: 10.3322/caac.21637.Miller KD, Fidler-Benaoudia M, Keegan TH, Hipp HS, Jemal A, Siegel RL. Cancer statistics for adolescents and young adults, 2020. CA Cancer J Clin. 2020; 70(6): 443-459. doi: 10.3322/caac.21637.Elta GH, Enestvedt BK, Sauer BG, Lennon AM. ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts. Am J Gastroenterol. 2018; 113(4): 464-479. doi: 10.1038/ajg.2018.14.Elta GH, Enestvedt BK, Sauer BG, Lennon AM. ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts. Am J Gastroenterol. 2018; 113(4): 464-479. doi: 10.1038/ajg.2018.14.ASGE Standards of Practice Committee; Muthusamy VR, Chandrasekhara V, Acosta RD, Bruining DH, et al. The role of endoscopy in the diagnosis and treatment of cystic pancreatic neoplasms. Gastrointest Endosc. 2016; 84(1): 1-9. doi: 10.1016/j.gie.2016.04.014.ASGE Standards of Practice Committee; Muthusamy VR, Chandrasekhara V, Acosta RD, Bruining DH, et al. The role of endoscopy in the diagnosis and treatment of cystic pancreatic neoplasms. Gastrointest Endosc. 2016; 84(1): 1-9. doi: 10.1016/j.gie.2016.04.014.Karoumpalis I, Christodoulou DK. Cystic lesions of the pancreas. Ann Gastroenterol. 2016; 29(2): 155-61. doi: 10.20524/aog.2016.0007.Karoumpalis I, Christodoulou DK. Cystic lesions of the pancreas. Ann Gastroenterol. 2016; 29(2): 155-61. doi: 10.20524/aog.2016.0007.Lloyd RV, Osamura RY, Kloppel G, Rosai J, editors. World Health Organization classification of tumours of endocrine organs. In: World Health Organization classification of tumours. 4th edition. Vol. 10. Lyon: IARC Press; 2017. 355 p.Lloyd RV, Osamura RY, Kloppel G, Rosai J, editors. World Health Organization classification of tumours of endocrine organs. In: World Health Organization classification of tumours. 4th edition. Vol. 10. Lyon: IARC Press; 2017. 355 p.

The authors declare that there are no conflicts of interest present.