Yao Jie, Qian Jian-Jun, Zhu Chang-Ren, Bai Dou-Sheng, Miao Yi
Departments of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China ;
Oncol Lett. 2013 Aug;6(2):568-570. doi: 10.3892/ol.2013.1411. Epub 2013 Jun 18.
Sarcomatoid carcinoma of the pancreas is extremely rare. The current report presents a case of carcinosarcoma of the pancreas in a 48-year-old male. Pre-operative computed tomography scans revealed a large complex cystic and solid mass in the tail of the pancreas; the patient underwent a laparoscopic spleen-preserving left pancreatectomy. The tumor was shown to be made of cystic and solid components, with a grossly grey/ white appearance. A histological evaluation of the tumor revealed two elements separated from each other, one component was a pancreatic ductal adenocarcinoma and the other component exhibited a sarcomatous growth pattern, composed of spindle cells and multinucleated giant cells. Immunohistochemically, the epithelial area was positive for cytokeratin (CK) and negative for vimentin, while the sarcomatoid area was negative for CK and positive for vimentin. These observations confirmed a diagnosis of pancreatic carcinosarcoma. Although the patient was treated by gemcitabine following surgery, the outcome was extremely poor and the patient succumbed to sarcomatoid carcinoma three months after the treatment.
胰腺肉瘤样癌极为罕见。本报告介绍了一例48岁男性胰腺癌肉瘤病例。术前计算机断层扫描显示胰腺尾部有一个巨大的复杂囊实性肿块；患者接受了保留脾脏的腹腔镜左胰腺切除术。肿瘤由囊性和实性成分组成，外观呈灰白色。对肿瘤进行组织学评估发现有两种相互分离的成分，一种成分是胰腺导管腺癌，另一种成分呈现肉瘤样生长模式，由梭形细胞和多核巨细胞组成。免疫组织化学检查显示，上皮区域细胞角蛋白（CK）呈阳性，波形蛋白呈阴性，而肉瘤样区域CK呈阴性，波形蛋白呈阳性。这些观察结果证实了胰腺癌肉瘤的诊断。尽管患者术后接受了吉西他滨治疗，但其预后极差，治疗三个月后死于肉瘤样癌。
