Sarcomatoid carcinoma of the pancreas — multimodality imaging findings with serial imaging follow-up: A case report and review of literature

Table 1 Summary of the clinical and radiologic imaging features of the reported pancreatic sarcomatoid carcinoma in the English literature

No.	Ref.	Age/sex	Clinical manifestation	CA19-9/CEA	Site	Size	Imaging findings	Pancreatic duct dilatation	Preoperative diagnosis	Treatment	Cause of death	Survival (mo)
1	Wenig et al[14], 1997	67/M	Abdominal pain	NA	Tail	19 cm × 14 cm × 8 cm	Complex, partially cystic lesion	(-)	Pseudocyst	Distal pancreatectomy with splenectomy	Extensive intra-abdominal involvement	15
2	Pan and Wang[21], 2007	70/F	Anemia, weight loss	NA	Body, tail	10.4 cm × 8.3 cm × 6.6 cm	Cystic-solid mass	(-)	NA	Distal pancreatectomy with splenectomy	NA	> 4
3	Gelos et al[22],2008	61/F	Anemia	NA	Head	7 cm × 6 cm × 3.5 cm	Mass	NA	NA	PD	Peritoneal carcinomatosis	11
4	Nakano et al[23],2008	82/F	Anorexia	231/15	Head	18 cm × 11 cm × 10 cm	Cystic-solid mass	(+)	NA	PD with transverse colonic segmental resection	Sepsis	13 d
5	Okamura et al[24],2010	64/F	Incidentally found	87/2.7	Tail	2 cm	Cystic-solid mass	(+)	IPMN	Distal pancreatectomy	NA	> 12
6	Shen et al[25], 2010	72/F	Abdominal pain, nausea, vomiting	Normal	Head	5 cm × 4 cm × 4 cm	Cystic-solid mass	(-)	NA	PD with left, hepatic lobe resection	Recurrence in the tail/ multiple liver metastasis	2
7	Kim et al[26], 2011	48/M	Incidentally found	694.7/NA	Tail	5.5 cm × 5 cm × 5 cm	Cystic-solid mass	(-)	Pancreatic cancer with pseudocyst	Distal pancreatectomy, splenectomy with colonic segmental resection	Multiple hepatic/peritoneal metastasis	4
8	Palaniappan and Bindhu[15], 2011	46/M	Dyspepsia, jaundice	252/NA	Head	3.4 cm × 3.4 cm × 1.5 cm	Hypodense, oval lesion	(+)	NA	PD	NA	> 28
9	Zhu et al[16], 2012	53/F	Abdominal pain, jaundice	89.08/NA	Head	5 cm × 4 cm × 3 cm	Mass	(+)	NA	PD	NA	> 20
10	Oymaci et al[27],2013	66/M	Abdominal pain, jaundice	NA	Head	3.5 cm × 2.0 cm × 1.5 cm	Cystic mass with hyperdense mural nodule	(-)	NA	PD	Upper gastrointestinal bleeding	20 d
11	Yao et al[28],2013	48/M	Epigastralgia, weight loss	134/12	Tail	10 cm × 8 cm × 5 cm	Cystic-solid mass	(-)	Cystadenoma	Laparoscopic spleen-preserving left pancreatectomy	Recurrence	3
12	Kim et al[29],2014	77/M	Poorly controlled blood sugar	160.57/NA	Body	2.2 cm	Mass	(+)	Pancreatic cancer	Biopsy and chemotherapy	NA	NA
13	Katsourakis et al[17], 2015	70/M	Anemia	169.67/NA	Head	4.7 cm × 4.5 cm	Mass	(+)	NA	PD	NA	> 16
14	Lai et al[30], 2015	55/M	Abdominal discomfort, weight loss	Normal	Body, tail	14 cm	Heterogeneous hypodense mass	NA	NA	Distal pancreatectomy with splenectomy, and resection of the proximal jejunum, and transverse colon	NA	NA
15	Lee et al[31], 2015	24/F	Epigastric pain, weight loss	7.7/7.1	Tail	4.7 cm × 3.5 cm	Cystic-solid mass	(-)	Solid pseudopapillary tumor	Distal pancreatectomy with splenectomy	NA	NA
16	Shi et al[10], 2015	74/F	Abdominal pain	148.4/10.05	Tail	2.2 cm × 2 cm	Cystic-solid mass	(-)	Mucinous cystadenocarcinoma	Distal pancreatectomy with splenectomy	NA	NA
17	Jia et al[18], 2017	44/F	Abdominal discomfort	> 1200/NA	Head	2.9 cm × 1.6 cm	Nodular hyperdense mass	(+)	NA	PD	NA	> 31
18	Li et al[6], 2017	60/M	Steatorrhea, weight loss, abdominal mass	Elevated	Head	10 cm × 9 cm × 9 cm	Cystic-solid mass	(+)	IPMN	Total pancreatectomy with splenectomy	NA	> 2
19	Mszyco et al[13], 2017	85/M	Abdominal pain, weight loss	NA/NA	Head	7.2 cm × 7.2 cm	Mixed solid and cystic mass, mild peripheral enhancement	(+)	NET, mucinous cystadenocarcinoma	PD	NA	NA
20	Ruess et al[7], 2017	73/F	Epigastric pain	29.1/10.2	Head	4	Abrupt change in caliber of the main pancreatic duct	(+)	Combined type IPMN with high-risk features	PD	Poor general condition	4
21	Xie et al[19], 2018	63/M	Epigastralgia, jaundice, weight loss	Normal	Head	2.5 cm × 2 cm × 1.8 cm	Bile duct dilation and abrupt narrowing at the distal CBD	(+)	Distal bile duct cancer	PD	Hepatic metastasis	18
22	Liu et al[20], 2019	66/M	Jaundice	NA	Head	4.1 cm × 3.3 cm × 2.2 cm	Irregularly shaped mass with an unclear boundary	(+)	NA	Bile duct jejunum anastomosis and radioactive seed implantation	NA	> 12
23	Zhou et al[32], 2019	59/M	Jaundice	14.6/NA	Head	1.5 cm × 1.1 cm	Hypodense mass with slightly enhancement	(+)	NA	PD	Hepatic metastasis, peritoneal metastasis	6
24	Quinn et al[33], 2020	42/F	Epigastric pain	NA	Body, tail	11.3 cm × 7.34 cm × 10.6 cm	Complex cystic, multiloculated	(-)	NA	Subtotal pancreatectomy, splenectomy, Lt. partial adrenalectomy, Lt. hemicolectomy	NA	> 15

CA19-9: Carbohydrate antigen 19-9 (U/mL, reference < 27 U/mL); CEA: Carcinoembryonic antigen (ng/mL, reference < 4.7 ng/mL); F: Female; M: Male; NA: Not available; IPMN: Intraductal papillary mucinous neoplasm; NET: Neuroendocrine tumor; PD: Pancreaticoduodenectomy.