소아의 췌장 종양
Pediatric Pancreatic Tumors
대한암학회지 1999년 31권 4호 p.830 ~ 835
소속 상세정보
김대연/Dae Yeon Kim
최민규/김기홍/김인원/정성은/이성철/박귀원/김우기/Min Gew Choi/Ki Hong Kim/In One Kim/Sung Eun Jung/Seong Cheol Lee/Kwi Won Park/Woo Ki Kim
KMID : 0360319990310040830
Abstract
서론
소아의 췌장 종양은 드문 질환으로 성인과 크게 다른 예후를 보인다. 소아에서의 췌장 종
양의 발생 빈도는 잘 알려져 있지 않지만, Jaksic등에 의하면 18,000 외과 수술당 1예이고,
Tsukimoto등에 의하면 부검 시 악성 종양으로 인한 소아사망의 0.2%로 보고하고 있다. 소
아에 발생한 췌장 종양은 1818년 Todd가 14세 여아의 췌장암을 처음으로 보고한 이래 지금
까지 문헌 검토 상 150예 이상이 보고되었다. 저자들은 서울대학교 어린이병원에서 1984년
부터 1998년까지 경험한 소아의 췌장 종양의 임상 양상과 치료 결과를 분석하였다.
Purpose: Pancreatic tumors are relatively rare in children. Until now more than 150
cases have been reported in the English literature. In this paper, the authors report the
tumor's clinical characteristics and the results of surgery in eleven children.
Materials and Methods: Eleven cases of pancreatic tumor pathologically verified at
Seoul National University Children's Hospital between 1984 to 1998 were retrospectively
analyzed. Four were boys and seven were girls, and their mean age at diagnosis was
7.7(range, 2∼13) years.
Results: There were six solid and papillary epithelial neoplasms of the pancreas
(SPENP) and five pancreatoblastomas. All children came to medical attention because of
abdominal masses. Tumors ranged in size from 6.0×5.0 ㎝ to 10.5×8.0 ㎝. Eight tumors
were located in head and three in tail. Complete excision was performed in eight cases
(six in SPENP and two in pancreatoblastoma). Incomplete excision was performed in
two cases of pancreatoblastoma. One patient with pancreatoblastoma had an unresectable
tumor at the time of diagnosis and needle aspiration biopsy was done under the
ultrasound guidance. No patient died during surgery. After a mean follow-up period of
4.1 years, all patients with SPENP were alive and there had been no recurrence.
However, of two patients who received complete excision in pancreatoblastoma, one
presented with liver metastasis at 4 months after operation and received chemotherapy,
but died 6 months after operation. The other patient had local recurrence 1 year after
operation. Reoperation and chemotherapy were performed and the child is now alive
without evidence of disease months after the initial operation. All three patients with
unresectable tumor died in spite of adjutant radiotherapy and chemotherapy.
Conclusion: Pediatric pancreatic tumors comprise rare heterogenous groups of
malignancies with their prognosis dependent upon adequate resection and pathologic
classification. Complete resection of pancreatic tumors arising anywhere in the pancreas
was recommended.
키워드
Pancreatic tumor; Pancreatoblastoma; Solid and papillary epithelial neoplasms of pancreas; Children;
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