Sarcomatoid carcinoma of the pancreas presenting as gastric carcinoma: Clinicopathologic and ultrastructural findings

Abstract

The clinicopathologic and ultrastructural features of a sarcomatoid carcinoma of the pancreas presenting initially as gastric carcinoma are described. By light microscopy, the tumor contained cellular patterns similar to those present in tumors of mesenchymal origin. Spindle cell areas arranged in a storiform pattern were present. Ultrastructurally, bundles of cytoplasmic microfilaments were present in the cell cytoplasm and were similar in distribution to those found on fine structural examination in tumors of mesenchymal origin. Rows of desmosomes were found between cells supporting an epithelial origin for this tumor. Following initial therapy, metastatic tumor produced polypoid lesions in the small intestine resulting in recurrent small bowel intussuceptions. Our findings indicate that sarcomatoid carcinoma of the pancreas, by both light and ultrastructural examination, is a heterogenous tumor at the cellular level and may be a cause of repeated intussuception when intraluminal compromise occurs.

Sarcomatoid carcinoma of the pancreas — a rare tumor with an uncommon presentation and course: A case report and review of literature

“…UPC is categorized into two different types: undifferentiated carcinoma [with three variants: anaplastic undifferentiated carcinoma, sarcomatoid carcinoma (SCP), and carcinosarcoma] and undifferentiated carcinoma with osteoclast-like giant cells[ 5 , 12 ]. Hence, we present a case of SCP that is an extremely rare type of tumor, with only a few cases reported in the literature[ 5 , 9 , 10 , 13 - 21 , 31 - 36 ]…”

A clinicopathologic and immunohistochemical study of 35 anaplastic carcinomas of the pancreas with a review of the literature

“…5,6,40 In our cases, direct spread to the surrounding soft tissues, stomach, spleen, and peritoneum was similar to those reported in the literature. 6,80 While infrequent, metastatic deposits were occasionally better differentiated than the primary tumor.…”

Pancreatic leiomyosarcoma

“…Since 1951 when Ross presented the first case [20], very few additional leiomyosarcomas have been reported [1, 3, 6, 11-13, 15, 19, 22, 25, 27]. The differential diagnosis of leiomyosarcoma includes highly anaplastic ductal adenocarcinomas, which have significant pleiomorphism or bizarre giant cells [26], and the carcinomas of fusiform cells (spindle cell or sarcomatoid carcinomas) must also be considered [5]. Negative cytokeratin and positive vimentin staining ruled out an epithelial origin for our tumour.…”