Solid pancreatic masses: What’s hidden beneath? Insights into rare pancreatic lesions

Abstract

The diagnostic approach to solid pancreatic masses has significantly evolved from the era when a focal pancreatic mass was almost synonymous to pancreatic ductal adenocarcinoma, to a wide spectrum of pancreatic lesions, some of which have good prognosis. With the advent of advanced diagnostic tools, particularly refined imaging and tissue acquisition techniques, a broader spectrum of differential diagnoses has been recognized, encompassing conditions ranging from neuroendocrine tumors or inflammatory masses, to rare entities like metastatic clear cell sarcoma or solitary fibrous tumors. We herein discuss case reports of some rare pancreatic lesions, which were diagnosed by combining clinical and imaging features and endoscopic ultrasound-guided tissue sampling and confirmed on surgical specimens. Further reports on these rare pancreatic tumors will contribute to a better understanding of their pathogenesis and effective management.

Keywords: Pancreatic mass; Pancreas; Metastasis; Diagnosis; Endoscopic ultrasound

Core Tip: The diagnostic landscape for solid pancreatic masses has expanded beyond the traditional assumption of pancreatic ductal adenocarcinoma and few other more common lesions. Advancements in imaging, tissue sampling, and histopathological techniques, have unveiled a wide spectrum of pancreatic lesions, including rare tumors. In this editorial, we comment on case reports of some rare pancreatic lesions, such as metastatic clear cell sarcoma of the pancreas and pancreatic solitary fibrous tumor, emphasizing the importance of a comprehensive diagnostic approach integrating medical history, cross-sectional imaging, and endoscopic ultrasound-guided tissue sampling.