Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3102
Peer-review started: November 12, 2020
First decision: January 17, 2021
Revised: January 28, 2021
Accepted: March 4, 2021
Article in press: March 4, 2021
Published online: May 6, 2021
Processing time: 161 Days and 11.1 Hours
Sarcomatoid carcinoma of the pancreas is extremely rare and has an extremely poor prognosis. Although a few cases of sarcomatoid carcinoma of pancreas have been reported, most are focused on a histopathological review. To the best of our knowledge, there are no reports documenting multimodality imaging characteristics and chronological changes with emphasis on radiologic features.
A 64-year-old woman was admitted to Chungnam National University Hospital with acute appendicitis. Contrast-enhanced computed tomography of the abdomen revealed a 2.6 cm × 2.8 cm multilobular cystic mass in the pancreatic tail. The pancreatic lesion showed suspected mural nodules and thin septa. Hence, mucinous cystic neoplasm of pancreas was considered. After 7 mo, the patient was readmitted for repeated epigastric abdominal pain and nausea. Follow-up contrast-enhanced computed tomography of the abdomen and magnetic resonance imaging revealed a marked enlargement (5.4 cm × 4 cm), with a predominant internal solid component. The mass showed low signal intensity on a T1-weighted image and heterogeneously intermediate high signal intensity on a T2-weighted image. It showed diffusion restriction and peripheral rim enhancement on an arterial phase image, and progressive enhancement on portal venous and delayed phase images. Distal pancreatectomy was performed. Based on the morphology and immunohistochemical staining of the specimen, pancreatic sarcomatoid carcinoma was diagnosed.
We present the computed tomography, magnetic resonance imaging, and positron emission tomography computed tomography findings, pathologic features, and chronological changes for preoperative diagnosis.
Core Tip: Sarcomatoid carcinoma of the pancreas is extremely rare and has a poor prognosis. Herein, we present the rapid disease progression with a focus on the chronological multimodality imaging findings. We also summarize the radiologic findings including preoperative diagnosis based on the appended computed tomography and magnetic resonance imaging scans. The main imaging finding of pancreatic sarcomatoid carcinoma is a multilobular, cystic and solid mass showing rapid growth.