Undifferentiated pancreatic pleomorphic sarcoma
A 72-year-old female patient was referred to the hospital for further evaluation and surgical operation of pancreatic head and neck carcinoma. On examination the pain was postprandial and localised to the right upper abdomen. Doctors diagnosed the patient with pleomorphic sarcoma of pancreas. The patient had a 1-year history of abdominal pain which had become worse in the last 6 months.
The pain was postprandial and localised to the upper abdomen. There was no history of alcohol consumption or smoking. Doctors suspected the patient of having pancreatic head and neck carcinoma. Therefore, referred him for consultation with surgery. She was implanted a plastic stent in the previous health centre to relieve symptoms of intra- and extrahepatic duct dilation. An abdominal CT scan, endosonographic imaging and ampullary biopsy were done. The imaging showed a hypodense mass at the head and neck of the pancreas, measuring 18 mm x 20 mm. Periampullary lesions were ruled out with endosonographic imaging. In addition to this, imaging also showed a dilated pacreatic duck and distally thickened common bile duct with sludge. Diagnostic biopsy confirmed the diagnosis of pleomorphic sarcoma of the pancreas.
Treatment included total pancreatectomy.
Postoperative pathological studies indicated a tumour with a dimension of 4 cm, extending to the duodenum. There were signs of invasion of venous, lymphatic and perineural sites. However, there were no signs of distant metastases. Similarly, the bile flow was being hindered over time with the periampullary occlusion, which led to cholecystitis and pancreatitis. Hematoxylin and eosin staining showed the presence of two cellular populations with spindle fibroblast-like and pleomorphic cells within the tumour. Contrast-enhanced thoracic high-resolution CT scan and multidetector CT scan of abdominopelvic did not reveal any metastases even after 36 months of being operated. She was disease-free during her 5-year follow up.
Undifferentiated Pleomorphic Sarcoma of Pancreas: A Case Report and Review of the Literature for the Last Updates https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6000869/