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Case Reports
. 2019 Jan 26;7(2):236-241.
doi: 10.12998/wjcc.v7.i2.236.

Sarcomatoid carcinoma of the pancreas: A case report

Dong-Kai Zhou  1 , Bing-Qiang Gao  1 , Wang Zhang  1 , Xiao-Hui Qian  1 , Li-Xiong Ying  2 , Wei-Lin Wang  1
Affiliations
Case Reports

Sarcomatoid carcinoma of the pancreas: A case report

Dong-Kai Zhou et al. World J Clin Cases. .

Abstract

Background: Sarcomatoid carcinoma of the pancreas (SCP) is a rare and aggressive epithelial tumor that has both epithelial and mesenchymal features. It is characterized by sarcomatous elements with evidence of epithelial differentiation. And the term "sarcomatoid carcinoma" is often confused with "carcinosarcoma".

Case summary: We present a case of SCP with lymph node metastasis in a 59-year-old male patient. He had experienced darkening of the urine, scleral icterus, and fatigue for 4 weeks. Computed tomography and magnetic resonance imaging revealed a mass in the pancreatic head, and laboratory tests revealed elevated serum bilirubin levels. The patient underwent pancreaticoduodenectomy after biliary decompression. Histologically, spindle cells with marked nuclear atypia and brisk mitotic activity arranged in a storiform or fascicular pattern were present in the bulk of the tumor. Immunohistochemical analysis found that the spindle cells exhibited strong diffuse positivity for epithelial markers, indicative of epithelial differentiation. Accordingly, the pathologic diagnosis of the pancreatic neoplasm was SCP.

Conclusion: Although sarcomatoid carcinomas and carcinosarcomas have different pathologic features, both have epithelial origin.

Keywords: Carcinosarcomas; Case report; Pancreas; Sarcomatoid carcinoma; Spindle cell; Undifferentiated carcinomas.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this report.

Figures

Figure 1
Figure 1
Arterial phase computed tomography images. A: A low-density round mass measuring about 1.5 cm × 1.1 cm in the pancreatic head; B: Dilated pancreatic duct.
Figure 2
Figure 2
Pathological examination of the lesion in the pancreatic head. A: Spindle cells with marked nuclear atypia and brisk mitotic activity arranged in a storiform or fascicular pattern (hematoxylin and eosin staining); B, C: Spindle cells exhibited strong diffuse positivity for cytokeratin 19 (B) and vimentin (C).
Figure 3
Figure 3
Pathological examination of the metastatic lymph nodes. A: Spindle cells with marked nuclear atypia and brisk mitotic activity arranged in a storiform or fascicular pattern (hematoxylin and eosin staining); B, C: Spindle cells exhibited strong diffuse positivity for cytokeratin 19 (B) and vimentin (C).
See this image and copyright information in PMC

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