Anlotinib in combination with pembrolizumab for low-grade myofibroblastic sarcoma of the pancreas: A case report

Abstract

BACKGROUND

Low-grade myofibroblastic sarcoma (LGMS) is a rare spindle cell sarcoma especially in the pancreas, with myofibroblastic differentiation. Hitherto, only a few cases have been reported.

CASE SUMMARY

Herein, we report a case involving the discovery of a pancreatic mass detected during a routine physical examination. Subsequent imaging and pathological tests of the patient led to the diagnosis of LGMS of the pancreas. Following surgical intervention, the patient experienced recurrence and metastasis. Conventional treatment is not effective for postoperative recurrent pancreatic LGMS with multiple metastases. After communicating with the patients and their families, informed consent was obtained for the treatment of anlotinib combined with pembrolizumab. Evaluation of imaging and clinical symptoms post-treatment revealed a relatively favorable response to the combination of anlotinib and pembrolizumab.

CONCLUSION

Based on the comprehensive literature review, our report aimed to provide evidence for a better understanding of the disease characteristics, diagnostic criteria, imaging findings, and identification of LGMS. And explore novel treatment strategies for this disease.

Keywords: Low-grade myofibroblastic sarcoma; Pancreas; Pembrolizumab; Anlotinib; Immunohistochemistry; Pathology; Case report

Core Tip: Low-grade myofibroblastic sarcoma (LGMS) is a rare spindle cell sarcoma with myofibroblastic differentiation. It is predominantly located in the head, neck, and extremities, whereas less frequently in the abdominal cavity, especially the pancreatic region. LGMS is characterized by a low-grade malignancy and low risk of recurrence and metastases. To date, complete surgical resection remains the primary treatment modality. Despite chemoradiotherapy showing anti-tumor activity for the treatment of postoperative recurrence and metastasis, it remains controversial. Until recently, no effective treatment for LGMS patients intolerant to chemoradiotherapy has been well established. This article aims to explore the new idea of LGMS based on literature obtained from PubMed and a clinical case.