Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun 17;6(1):139.
doi: 10.1186/s40792-020-00907-9.

Resection of pancreatic and splenic metastases from alveolar soft part sarcoma: a case report

Satoshi Arakawa  1 , Yukio Asano  2 , Norihiko Kawabe  2 , Hidetoshi Nagata  2 , Yuka Kondo  2 , Shinpei Furuta  2 , Masahiro Shimura  2 , Chihiro Hayashi  2 , Takayuki Ochi  2 , Kenshiro Kamio  2 , Toki Kawai  2 , Hironobu Yasuoka  2 , Takahiko Higashiguchi  2 , Shin Ishihara  2 , Masahiro Ito  2 , Yoshihiro Imaeda  2 , Akihiko Horiguchi  2
Affiliations

Resection of pancreatic and splenic metastases from alveolar soft part sarcoma: a case report

Satoshi Arakawa et al. Surg Case Rep. .

Abstract

Background: We present a case of pancreatic and splenic metastases following alveolar soft part sarcoma (ASPS), which was successfully treated by surgery.

Case presentation: A 41-year-old male was referred to our hospital in 2012. Computed tomography (CT) showed the presence of a pancreatic tumor. In 2002, the patient had undergone surgical resection of an ASPS of the anal region. In 2009, during follow-up, CT revealed lung metastases, which prompted surgical resection of the lung, followed by resection of the head skin in 2011. Abdominal ultrasonography (US) revealed the presence of isodense masses sized 34 mm in the pancreatic head and 60 mm within the spleen. The contrast-enhanced US revealed a solitary lesion with enhancement. Contrast-enhanced CT revealed solitary lesions with enhancement within the pancreatic head, spleen, and liver. The patient underwent metastasectomies from the pancreas, spleen, and liver. The patient was discharged on postoperative day 22 without recurrence for 18 months after metastasectomy. Twelve years after primary resection and 2 years after metastasectomy, the patient died as a consequence of multiple metastases.

Conclusions: We have presented a rare case of pancreatic and spleen metastases from ASPS. Resection by radical metastasectomy was successful without morbidity. Thus, for improved survival of patients with multiple metastases from ASPS, metastasectomy may be indicated. If multiple metastases are resectable, surgical approaches may be the preferred treatment.

Keywords: Alveolar soft part sarcoma; Metastasectomy; Metastases; Pancreatic tumor.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Abdominal ultrasonography (US) with and without contrast. Abdominal US with and without contrast revealed the presence of isodense masses of 34 mm (a) in the pancreatic head and 60 mm and in the spleen (b) (arrows)
Fig. 2
Fig. 2
Contrast-enhanced computed tomography (CT) (horizontal slice). Contrast-enhanced CT revealed solitary lesions with enhancement in the liver (a), spleen (b), and pancreatic head (c) (arrow)
Fig. 3
Fig. 3
Findings of the resected specimen. The macroscopic and microscopic findings of the cut specimen revealed gray and clear borders between the tumor and pancreas (a, b) and spleen (c, d), and yellow and unclear border between the tumor and liver. Pathological examination showed that atypical cells with eosinophilic granular cytoplasm had proliferated to form alveolar solid nests in the pancreas (e, f) and spleen (g, h). The pathological examination further showed focal nodular hyperplasia at the liver
Fig. 4
Fig. 4
Immunohistochemistry analysis in primary ASPS, and pancreatic and splenic metastases (Desmin and Ki-67 original magnification x 200). Primary ASPS (a), pancreatic metastases (b), and splenic metastases (c) had Desmin-positive foci. The antigen Ki-67 proliferation index was < 10% in primary ASPS (d), pancreatic metastases (e), and splenic metastases (f)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Christopherson WM, Foote FW, Jr, Stewart FW. Alveolar soft part sarcomas: structurally characteristic tumors of uncertain histogenesis. Cancer. 1952;5:100–111. doi: 10.1002/1097-0142(195201)5:1<100::AID-CNCR2820050112>3.0.CO;2-K. - DOI - PubMed
    1. Enzinger FM, Weiss SW. Malignant tumors uncertain type. In: Enzinger FM, Weiss SW, editors. Soft tissue tumors. St. Louis: Mosby; 1995. pp. 1067–1074.
    1. Portera CA, Ho V, Patel SR, Hunt KK, Feig BW, Respondek PM, et al. Alveolar soft part sarcoma: clinical course and patterns of metastasis in 70 patients treated. Cancer. 2001;91:585–591. doi: 10.1002/1097-0142(20010201)91:3<585::AID-CNCR1038>3.0.CO;2-0. - DOI - PubMed
    1. Abrams HL, Spiro R, Goldstein N. Metastasis in carcinoma. Analysis of 1000 autopsied cases. Cancer. 1950;3:74–85. doi: 10.1002/1097-0142(1950)3:1<74::AID-CNCR2820030111>3.0.CO;2-7. - DOI - PubMed
    1. Reddy S, Wolfgang CL. The role of surgery in the management of isolated metastases to the pancreas. Lancet Oncol. 2009;10:287–293. doi: 10.1016/S1470-2045(09)70065-8. - DOI - PubMed

LinkOut - more resources