Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Sarcomatoid carcinoma of the pancreas — multimodality imaging findings with serial imaging follow-up: A case report and review of literature
Hyun Jae Lim, Hye Seon Kang, Jeong Eun Lee, Ji Hye Min, Kyung Sook Shin, Sun Kyoung You, Kyung-Hee Kim
Hyun Jae Lim, Hye Seon Kang, Department of Radiology, Chungnam National University Hospital, Daejeon 35015, South Korea
Jeong Eun Lee, Kyung Sook Shin, Sun Kyoung You, Department of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon 35015, South Korea
Ji Hye Min, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
Kyung-Hee Kim, Department of Pathology, Cancer Research Institute, College of Medicine, Chungnam National University, Daejeon 35015, South Korea
Author contributions: Lim HJ, Kang HS, Lee JE, Min JH, Shin KS and You SK performed the imaging analyses, and interpretation and contributed to manuscript drafting; Kim KH performed the pathological analyses and interpretation, and contributed to manuscript drafting; Lee JE was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jeong Eun Lee, MD, PhD, Assistant Lecturer, Department of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, South Korea. leeje290@gmail.com
Received: November 12, 2020
Peer-review started: November 12, 2020
First decision: January 17, 2021
Revised: January 28, 2021
Accepted: March 4, 2021
Article in press: March 4, 2021
Published online: May 6, 2021
BACKGROUND
Sarcomatoid carcinoma of the pancreas is extremely rare and has an extremely poor prognosis. Although a few cases of sarcomatoid carcinoma of pancreas have been reported, most are focused on a histopathological review. To the best of our knowledge, there are no reports documenting multimodality imaging characteristics and chronological changes with emphasis on radiologic features.
CASE SUMMARY
A 64-year-old woman was admitted to Chungnam National University Hospital with acute appendicitis. Contrast-enhanced computed tomography of the abdomen revealed a 2.6 cm × 2.8 cm multilobular cystic mass in the pancreatic tail. The pancreatic lesion showed suspected mural nodules and thin septa. Hence, mucinous cystic neoplasm of pancreas was considered. After 7 mo, the patient was readmitted for repeated epigastric abdominal pain and nausea. Follow-up contrast-enhanced computed tomography of the abdomen and magnetic resonance imaging revealed a marked enlargement (5.4 cm × 4 cm), with a predominant internal solid component. The mass showed low signal intensity on a T1-weighted image and heterogeneously intermediate high signal intensity on a T2-weighted image. It showed diffusion restriction and peripheral rim enhancement on an arterial phase image, and progressive enhancement on portal venous and delayed phase images. Distal pancreatectomy was performed. Based on the morphology and immunohistochemical staining of the specimen, pancreatic sarcomatoid carcinoma was diagnosed.
CONCLUSION
We present the computed tomography, magnetic resonance imaging, and positron emission tomography computed tomography findings, pathologic features, and chronological changes for preoperative diagnosis.
Core Tip: Sarcomatoid carcinoma of the pancreas is extremely rare and has a poor prognosis. Herein, we present the rapid disease progression with a focus on the chronological multimodality imaging findings. We also summarize the radiologic findings including preoperative diagnosis based on the appended computed tomography and magnetic resonance imaging scans. The main imaging finding of pancreatic sarcomatoid carcinoma is a multilobular, cystic and solid mass showing rapid growth.
