Case Report
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World J Gastroenterol. Nov 21, 2013; 19(43): 7820-7824
Published online Nov 21, 2013. doi: 10.3748/wjg.v19.i43.7820
Unusual early-stage pancreatic sarcomatoid carcinoma
Chuan-Li Ren, Ping Jin, Chong-Xu Han, Qin Xiao, Dao-Rong Wang, Lin Shi, Da-Xin Wang, Hui Chen
Chuan-Li Ren, Ping Jin, Chong-Xu Han, Laboratory Medicine and Pathology Department, Northern Jiangsu People’s Hospital and Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Qin Xiao, Pathology Department, Northern Jiangsu People’s Hospital and Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Dao-Rong Wang, Abdominal Surgery Department, Northern Jiangsu People’s Hospital and Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Lin Shi, Transonogram Department, Northern Jiangsu People’s Hospital and Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Da-Xin Wang, Laboratory Medicine Centre Department, Northern Jiangsu People’s Hospital and Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Hui Chen, Geratology Department, Northern Jiangsu People’s Hospital and Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Author contributions: Ren CL, Jin P, Xiao Q, Shi L, Chen H and Han CX performed the majority of experiments; Wang DR, Shi L and Wang DX provided vital reagents and analytical tools, and were also involved in editing the manuscript; Ren CL and Chen H designed the study, wrote the manuscript, and provided support for this work.
Supported by China Postdoctoral Science Foundation, No. 2013M541699; Social Development of Jiangsu Province, No. BE2012705 and the Foundation of Northern Jiangsu People’s Hospital, No. Yzucms201213
Correspondence to: Hui Chen, MD, Geratology Department, Northern Jiangsu People’s Hospital and Clinical Medical College of Yangzhou University, No. 98 Western Nantong Road, Yangzhou 225001, Jiangsu Province, China. chenhuiyangzhou@163.com
Telephone: +86-514-87937516 Fax: +86-514-87937516
Received: August 13, 2013
Revised: September 8, 2013
Accepted: October 13, 2013
Published online: November 21, 2013
Processing time: 126 Days and 10.9 Hours
Abstract

Sarcomatoid carcinoma of the pancreas (SCP) is a very rare pathological type of carcinoma that usually has a poor prognosis. Its pathogenesis has not been elucidated. We herein report a case of an early-stage SCP involving successful treatment and a good prognosis. The patient was a 48-year-old Chinese man with a 5-mo history of vague abdominal pain. Ultrasonography revealed a 93 mm × 94 mm × 75 mm mass of mixed echogenicity in the tail of the pancreas. Laboratory test results were within the normal range, with the exception of an obviously increased pretreatment neuron-specific enolase level. The plasma transforming growth factor (TGF)β1 and interleukin-11 levels were obviously increased according to enzyme-linked immunosorbent assay. Microscopically, the excised tumor tissue comprised cancer cells and mesenchymal cells. Immunohistochemical analysis was positive for α-1-antichymotrypsin, pan-cytokeratin, cytokeratin 19, cytokeratin 8/18, and vimentin and negative for CD68 and lysozyme. The pathogenetic mechanism of this case shows that TGFβ1 may regulate the epithelial-to-mesenchymal transition in SCP. With early eradication of the tumor and systemic therapy, this patient has been alive for more than 3 years without tumor recurrence or distant metastasis. This case is also the first to show that TGFβ1 may regulate the epithelial-to-mesenchymal transition in early-stage SCP.

Keywords: Sarcomatoid carcinoma of the pancreas; Transforming growth factorβ1; Epithelial-to mesenchymal transition; Interleukin-11; Vimentin

Core tip: We herein report a case of an early-stage sarcomatoid carcinoma of the pancreas (SCP) involving successful treatment and a good prognosis. The plasma transforming growth factor (TGF)β1 and interleukin-11 levels were obviously increased according to enzyme-linked immunosorbent assay. Immunohistochemical analysis was positive for pan-cytokeratin, cytokeratin 8/18, and vimentin and negative for CD68 and lysozyme. The pathogenetic mechanism of this case shows that TGFβ1 may regulate the epithelial-to-mesenchymal transition in SCP. This case is also the first to show that TGFβ1 may regulate the epithelial-to-mesenchymal transition in early-stage SCP.