Laparoscopic left pancreatectomy for pancreatic sarcomatoid carcinoma: A case report and review of the literature

Abstract

Sarcomatoid carcinoma of the pancreas is extremely rare. The current report presents a case of carcinosarcoma of the pancreas in a 48-year-old male. Pre-operative computed tomography scans revealed a large complex cystic and solid mass in the tail of the pancreas; the patient underwent a laparoscopic spleen-preserving left pancreatectomy. The tumor was shown to be made of cystic and solid components, with a grossly grey/ white appearance. A histological evaluation of the tumor revealed two elements separated from each other, one component was a pancreatic ductal adenocarcinoma and the other component exhibited a sarcomatous growth pattern, composed of spindle cells and multinucleated giant cells. Immunohistochemically, the epithelial area was positive for cytokeratin (CK) and negative for vimentin, while the sarcomatoid area was negative for CK and positive for vimentin. These observations confirmed a diagnosis of pancreatic carcinosarcoma. Although the patient was treated by gemcitabine following surgery, the outcome was extremely poor and the patient succumbed to sarcomatoid carcinoma three months after the treatment.

Carcinosarcoma of the pancreas: comprehensive clinicopathological and molecular characterization

“…It has been shown that the overall survival is limited to 6 months in the majority of patients. 16 Another study showed that half of the patients died within 15 months afer surgery. 12 The median overall survival of patients in the present study was 14 months, comparing to 20 months of the classic PDAC.…”

Pancreatic carcinosarcoma mimics malignant intraductal papillary mucinous neoplasm

“…Only a handful of patients of PCS have been reported in the literature which are summarized in Additional file 1 (refer to Additional file 1, which summarizes the literatures). [ 5 , 7 – 23 ]…”

High-grade malignant pancreatic neoplasm with sarcomatoid features

“…Sarcomatoid carcinoma arising in pancreas is extremely rare, with only few cases reported in the literature (1)(2)(3)(4). Histologically, it is a subtype of undifferentiated pancreatic carcinoma composed predominantly of malignant spindle cells, with or without a coexisting epithelial cell component.…”