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

Yao,Jie; Qian,Jian-Jun; Zhu,Chang-Ren; Bai,Dou-Sheng; Miao,Yi

doi:10.3892/ol.2013.1411

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

Authors:
- Jie Yao
- Jian-Jun Qian
- Chang-Ren Zhu
- Dou-Sheng Bai
- Yi Miao
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Affiliations: Department of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital, The First Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China, Department of Pathology, Northern Jiangsu People's Hospital, The First Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China, Center of Pancreatic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
Published online on: June 18, 2013 https://doi.org/10.3892/ol.2013.1411
Pages: 568-570

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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.

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1.	Kloppel G, Solcia E, Longnecker DS, Capella C and Sobin LH; World Health Organization: International Histological Classification of Tumours. Histological Typing of the Exocrine Pancreas. 2nd Edition. Springer-Verlag; Berlin: pp. 12–19. 1996
2.	Freeman AJ, Bullpitt P and Keogh GW: Primary hepatic carcinosarcoma. ANZ J Surg. 74:1021–1023. 2004. View Article : Google Scholar
3.	Tsujimura T, Kawano K, Taniguchi M, Yoshikawa K and Tsukaguchi I: Malignant fibrous histiocytoma coexistent with mucinous cystadenoma of the pancreas. Cancer. 70:2792–2796. 1992. View Article : Google Scholar : PubMed/NCBI
4.	Millis JM, Chang B, Zinner MJ and Barsky SH: Malignant mixed tumor (carcinosarcoma) of the pancreas: a case report supporting organ-induced differentiation of malignancy. Surgery. 115:132–137. 1994.PubMed/NCBI
5.	van den Berg W, Tascilar M, Offerhaus GJ, et al: Pancreatic mucinous cystic neoplasms with sarcomatous stroma: molecular evidence for monoclonal origin with subsequent divergence of the epithelial and sarcomatous components. Mod Pathol. 13:86–91. 2000.
6.	Darvishian F, Sullivan J, Teichberg S and Basham K: Carcinosarcoma of the pancreas: a case report and review of the literature. Arch Pathol Lab Med. 126:1114–1117. 2002.PubMed/NCBI
7.	Watanabe M, Miura H, Inoue H, et al: Mixed osteoclastic/pleomorphic-type giant cell tumor of the pancreas with ductal adenocarcinoma: histochemical and immunohistochemical study with review of the literature. Pancreas. 15:201–208. 1997. View Article : Google Scholar
8.	Yamazaki K: A unique pancreatic ductal adenocarcinoma with carcinosarcomatous histology, immunohistochemical distribution of hCG-beta, and the elevation of serum alpha-feto-protein. J Submicrosc Cytol Pathol. 35:343–349. 2003.
9.	Shen ZL, Wang S, Ye YJ, et al: Carcinosarcoma of pancreas with liver metastasis combined with gastrointestinal stromal tumour of the stomach: is there a good prognosis with the complete resection? Eur J Cancer Care (Engl). 19:118–123. 2010. View Article : Google Scholar : PubMed/NCBI
10.	Gelos M, Behringer D, Philippou S and Mann B: Pancreatic carcinosarcoma. Case report of multimodal therapy and review of the literature. JOP. 9:50–55. 2008.PubMed/NCBI
11.	Zhu WY, Liu TG and Zhu H: Long-term recurrence-free survival in a patient with pancreatic carcinosarcoma: A case report with a literature review. Med Oncol. 29:140–143. 2012. View Article : Google Scholar : PubMed/NCBI
12.	Fischer HP, Altmannsberger M and Kracht J: Osteoclast-type giant cell tumour of the pancreas. Virchows Arch A Pathol Anat Histopathol. 412:247–253. 1988. View Article : Google Scholar : PubMed/NCBI
13.	Trepeta RW, Mathur B, Lagin S and LiVolsi VA: Giant cell tumor (“osteoclastoma”) of the pancreas: a tumor of epithelial origin. Cancer. 48:2022–2028. 1981.
14.	Bloomston M, Chanona-Vilchis J, Ellison EC, Ramirez NC and Frankel WL: Carcinosarcoma of the pancreas arising in a mucinous cystic neoplasm. Am Surg. 72:351–355. 2006.PubMed/NCBI
15.	Kooby DA, Hawkins WG, Schmidt CM, et al: A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg. 210:779–785. 786–787. 2010. View Article : Google Scholar : PubMed/NCBI
16.	Venkat R, Edil BH, Schulick RD, Lidor AO, Makary MA and Wolfgang CL: Laparoscopic distal pancreatectomy is associated with significantly less overall morbidity compared to the open technique: a systematic review and meta-analysis. Ann Surg. 255:1048–1059. 2012. View Article : Google Scholar : PubMed/NCBI