Lascivious constipation without appetite, is it a gastrointestinal stress response? Beware of pancreatic acinar cell carcinoma!

Just 30-year-old Ms. Zheng (pseudonym) is in the career upswing period, single-mindedly busy with her work, she often eats and drinks irregularly, when she has abdominal pain, strain, constipation, no appetite and other symptoms, she thinks it is just a gastrointestinal stress response, who knows that she has been targeted by tumors!

Guangzhou Daily Xinhuacheng reporter learned from the East Branch of the First Affiliated Hospital of Sun Yat-sen University on January 12 that after more than half a year of delay, Ms. Zheng only sought medical treatment due to aggravation of symptoms and was diagnosed with a very rare pancreatic acinar cell carcinoma. At present, after surgery + chemotherapy, her condition has been controlled and she has now returned to normal life.

From the onset of symptoms to the time she went to the doctor, she dragged on for more than half a year

At the end of 2019, Ms. Zheng suddenly had left upper quadrant pain, she thought it was just ordinary gastroenteritis, she took medicine casually, did not expect that the symptoms were repeated, good and bad. Half a year later, the frequency of pain became more and more dense, but also successively appeared thinning, constipation and decreased appetite, Ms. Zheng, who was lucky, thought that it was a gastrointestinal stress response caused by "strong work, irregular diet and rest, and decreased body immunity", and opened some traditional Chinese medicine to regulate the gastrointestinal tract in her hometown. In September 2020, Ms. Zheng found that her stomach was much larger, like 5-6 months pregnant, and the pain was getting stronger, and it was difficult to turn over, and she realized that it was not good. Sure enough, after seeking medical treatment, she was diagnosed with a tumor.

Because the tumor was too large, she traveled to many hospitals in Beijing, Shanghai and other hospitals due to the great risk of surgery and could not get a satisfactory treatment plan, and then she sought medical treatment from Professor Cui Ji of the Gastrointestinal Surgery Department of the First Affiliated Hospital of Sun Yat-sen University.

Through abdominal CT examination, it was found that Ms. Zheng had a huge soft tissue mass in her left upper abdomen, which was about 125 mm in size× 124 mm × 164 mm, equivalent to the size of a four-month-old fetus, with uneven density, a flaky low-density shadow, partially unclear border with the spleen, the spleen shifted to the upper left, while the stomach pressure shifted to the right, and the pancreas shifted to the right and back.

Combined with other tests, Professor Cui Ji's team preliminarily diagnosed Ms. Zheng's condition as pancreatic acinar cell carcinoma, which may have metastasis.

Fifty percent of patients have developed liver metastases as soon as they are diagnosed

"This is an extremely rare invasive malignant disease that is complicated by doping with pancreatic cytoma and mixed acinar endocrine tumors." Professor Cui Ji pointed out that although the incidence is not high, the recurrence rate is very high, according to the research data shows that it can reach more than 57%, and 50% of patients have liver metastases as soon as they are diagnosed. At present, the effect and benefit of radiotherapy and chemotherapy for this malignancy are limited, the treatment is mainly surgery, and the median survival of patients is only 19 months. Professor Cui Ji introduced.

Although the operation was extremely difficult, considering that Ms. Zheng was still very young, had a good physical background, and a strong will to survive, Professor Cui decided to give her a go. After repeated multidisciplinary consultations in oncology, radiology and other related departments, the combination of surgery and chemotherapy was finally determined.

Professor Cui Ji's team and Professor Yang Shibin's team jointly implemented the "abdominal giant tumor resection + splenectomy + colon part of the surgery", the amount of bleeding during the resection was small, the postoperative recovery was very good, and it took only 2 days to get out of bed.

At this time, another difficult problem has emerged, that is, how to implement chemotherapy to consolidate the therapeutic effect? After repeated consultations between Professor Cui Ji's team and Professor Li Heping's team in the Department of Oncology, they formulated a chemotherapy plan of targeted drugs plus immunotherapy for Ms. Zheng and implemented chemotherapy. After multiple chemotherapy treatments and repeated examinations, the tumor and peripheral lymph shrinkage. At present, Ms. Zheng has successfully returned to life and can go to work as usual.

Ms. Cheng presented a pennant to Professor Cui Ji

Health reminder: Abdominal pain is difficult to relieve should be treated as soon as possible

Professor Cui Ji reminded that if you encounter abdominal pain that cannot be relieved for a period of time, you must go to the hospital as soon as possible, do not take your own medicine, and delay medical treatment.

"Now many diseases have a trend of rejuvenation, young people do not fight to be young, uncomfortable to seek medical treatment in time, to avoid missing the best period of treatment." He stressed that although pancreatic acinar cell carcinoma is a rare malignant disease, with the development of medicine, multi-mode treatment combined with chemotherapy, radiotherapy and surgery has achieved results so far, and hopes that patients will maintain an optimistic attitude and fight cancer scientifically.

Text, photo/Guangzhou Daily, Xinhua city Reporter: Ren Shanshan Correspondents: He Xupeng, Zheng Yinan

Guangzhou Daily Xinhuacheng Editor: Li Jin