Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2019; 7(20): 3316-3321
Published online Oct 26, 2019. doi: 10.12998/wjcc.v7.i20.3316
Dermatofibrosarcoma metastases to the pancreas: A case report
Huai-Jie Cai, Jian-Hua Fang, Nan Cao, Wei Wang, Fan-Lei Kong, Xi-Xi Sun, Bin Huang
Huai-Jie Cai, Jian-Hua Fang, Nan Cao, Wei Wang, Fan-Lei Kong, The Fourth School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Xi-Xi Sun, Bin Huang, Department of Ultrasound, Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310023, Zhejiang Province, China
Author contributions: Cai HJ participated in the design of the report, analysed the data, and wrote the paper; Fang JH, Kong FL, and Wang W collected the medical imaging materials; Cao N, Sun XX, and Huang B designed the report and performed the preliminary revision of the article.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Bin Huang, MA, MSc, Chief Physician, Department of Ultrasound, Xixi Hospital affiliated to Zhejiang Chinese Medical University, No. 2, Hengbu Road, Xihu District, Hangzhou 310023, Zhejiang Province, China. hb2k@163.com
Telephone: +86-571-86481593 Fax: +86-571-86481561
Received: June 29, 2019
Peer-review started: July 1, 2019
First decision: August 2, 2019
Revised: August 12, 2019
Accepted: August 27, 2019
Article in press: August 27, 2019
Published online: October 26, 2019
Processing time: 119 Days and 13.4 Hours
Abstract
BACKGROUND

In general, malignant tumors metastasize to the pancreas in < 1% of cases. Most patients miss the opportunity for further surgery due to distant metastases; however, for fibrosarcomas, aggressive surgery may be helpful even if distant metastases occur. Hence, we report such a case and share some valuable information about the disease.

CASE SUMMARY

A 45-year-old man was admitted with recurrent epigastric pain for 10 days. The abdominal pain was mainly related to bloating with nausea, but no other associated symptoms. No particular signs were found on abdominal examination or laboratory testing. In 2003, a local distal expanded resection of the primary fibrosarcoma in the left chest wall was performed. Then, a left pneumonectomy was performed in 2017 due to diffuse metastases from the fibrosarcoma to the left lung. Enhanced computed tomography (CT) and magnetic resonance imaging of the upper abdomen suggested multiple masses of different sizes involving the head and tail of the pancreas; no local lymph node enlargement was noted. The postoperative pathologic diagnosis revealed a fibrosarcoma of the pancreas. A CT re-examination 6 mo postoperatively showed no local recurrence or distant metastases.

CONCLUSION

A fibrosarcoma is a rare low-grade malignant tumor, and metastases to the pancreas are even rarer. Patients with a history of a fibrosarcoma should consider the possibility of metastasis when a pancreatic neoplasm is demonstrated. Surgical resection is the preferred treatment.

Keywords: Pancreatic fibrosarcoma; Metastasis; Magnetic resonance imaging; Treatment; Case report

Core tip: The literature focusing on cutaneous fibrosarcoma metastases to the pancreas is extremely limited. We report a 45-year-old male patient who underwent a distal local dilation resection of a primary fibrosarcoma in the left chest wall in 2003 and a left pneumonectomy for left pulmonary fibrosarcoma metastases in 2017. Magnetic resonance imaging has specific characteristics, thus facilitating assessment of the extent of tumor invasion and whether or not there are peripheral lymph node metastases, which can help develop a reasonable treatment strategy for surgeons. Surgical excision is an effective treatment.