Toledo PF, Berger Z, Carreño L, Cardenas G, Castillo J, Orellana O. Sarcomatoid carcinoma of the pancreas — a rare tumor with an uncommon presentation and course: A case report and review of literature. World J Clin Cases 2021; 9(15): 3716-3725 [PMID: 34046475 DOI: 10.12998/wjcc.v9.i15.3716]
Corresponding Author of This Article
Zoltan Berger, MD, PhD, Professor, Department of Internal Medicine, Section Gastroenterology, Hospital Clinico Universidad de Chile, Santos Dumont 999, Santiago 834456, Independencia, Chile. berger.zoltan@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
World J Clin Cases. May 26, 2021; 9(15): 3716-3725 Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3716
Sarcomatoid carcinoma of the pancreas — a rare tumor with an uncommon presentation and course: A case report and review of literature
Paulina F Toledo, Zoltan Berger, Laura Carreño, Gonzalo Cardenas, Jaime Castillo, Omar Orellana
Paulina F Toledo, Department of Gastroenterology, Hospital Clinico Universidad de Chile, Santiago 834456, Independencia, Chile
Zoltan Berger, Department of Internal Medicine, Section Gastroenterology, Hospital Clinico Universidad de Chile, Santiago 834456, Independencia, Chile
Laura Carreño, Department of Pathology, Hospital Clínico de la Universidad de Chile, Santiago 834456, Independencia, Chile
Gonzalo Cardenas, Department of Radiology, Hospital Clínico Universidad de Chile, Santiago 834456, Independencia, Chile
Jaime Castillo, Omar Orellana, Department of Surgery, Hospital Clínico Universidad de Chile, Santiago 834456, Independencia, Chile
Author contributions: Toledo PF reviewed the literature and drafted the manuscript; Berger Z was the patient’s gastroenterologist who maintained medical follow-up and was responsible for critical revision of the article for important intellectual content; Carreño L performed the analyses and interpretation of the anatomopathological findings of the described tumor; Cárdenas G analyzed and interpreted the imaging findings; Castillo J and Orellana O were the patient’s digestive surgeons; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised accordingly.
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: Zoltan Berger, MD, PhD, Professor, Department of Internal Medicine, Section Gastroenterology, Hospital Clinico Universidad de Chile, Santos Dumont 999, Santiago 834456, Independencia, Chile. berger.zoltan@gmail.com
Received: December 28, 2020 Peer-review started: December 28, 2020 First decision: January 9, 2021 Revised: February 17, 2021 Accepted: March 24, 2021 Article in press: March 24, 2021 Published online: May 26, 2021
Abstract
BACKGROUND
Sarcomatoid carcinoma of the pancreas (SCP) is a rare type of pancreatic neoplasm, and only a few cases have been described in the literature. Histologically, it is composed mostly of atypical spindle cells with apparent sarcomatous features.
CASE SUMMARY
This is a report of a 61-year-old Chilean woman who underwent medical investigation for acute abdominal pain. Computed tomography identified a solid tumor in the tail of the pancreas with features suspicious of malignancy. En-bloc distal pancreatectomy and splenectomy were performed to excise the tumor. Histopathology and immunohistochemistry were confirmatory of sarcomatoid carcinoma with lymphovascular invasion. After surgery, the patient did not receive chemotherapy. Previous studies indicate a poor prognosis for this type of malignancy. However, our patient has survived for 35 mo with no recurrence to date.
CONCLUSION
The case presented herein is a patient with an SCP with a rare presentation and long-term survival after surgery despite not receiving adjuvant chemotherapy.
Core Tip: Sarcomatoid carcinoma of the pancreas (SCP) is an extremely rare and aggressive histologic subtype of undifferentiated pancreatic carcinoma. The prognosis of this neoplasm is similar to or even worse than that of typical pancreatic ductal adenocarcinoma (PDAC). However, the clinical course and surgical outcomes of SCP remain poorly characterized owing to its rarity. Because there is no standard regimen for treating SCP, patients with this disease are administered the same regimens as those with more common PDACs. In the present study, we report a case of SCP; although some patients have a rapid recurrence and early death, long-term survival may be possible.
