Published online Jan 26, 2019. doi: 10.12998/wjcc.v7.i2.236
Peer-review started: October 16, 2018
First decision: November 22, 2018
Revised: December 4, 2018
Accepted: December 7, 2018
Article in press: December 8, 2018
Published online: January 26, 2019
Sarcomatoid carcinoma of the pancreas (SCP) is a rare and aggressive epithelial tumor that has both epithelial and mesenchymal features. It is characterized by sarcomatous elements with evidence of epithelial differentiation. And the term “sarcomatoid carcinoma” is often confused with “carcinosarcoma”.
We present a case of SCP with lymph node metastasis in a 59-year-old male patient. He had experienced darkening of the urine, scleral icterus, and fatigue for 4 weeks. Computed tomography and magnetic resonance imaging revealed a mass in the pancreatic head, and laboratory tests revealed elevated serum bilirubin levels. The patient underwent pancreaticoduodenectomy after biliary decompression. Histologically, spindle cells with marked nuclear atypia and brisk mitotic activity arranged in a storiform or fascicular pattern were present in the bulk of the tumor. Immunohistochemical analysis found that the spindle cells exhibited strong diffuse positivity for epithelial markers, indicative of epithelial differentiation. Accordingly, the pathologic diagnosis of the pancreatic neoplasm was SCP.
Although sarcomatoid carcinomas and carcinosarcomas have different pathologic features, both have epithelial origin.
Core tip: Sarcomatoid carcinoma of the pancreas is a rare and aggressive epithelial tumor with a sarcoma-like element. The term “sarcomatoid carcinoma” is often confused with “carcinosarcoma”. In the present study, we report a case of sarcomatoid carcinoma arising in the pancreas and discuss the similarities and differences between sarcomatoid carcinomas and carcinosarcomas.