Spindle Cell Neoplasms of Pancreas
Year: 2024
Type: article
Study design: Case Report
Abstract: Spindle Cell Neoplasms of PancreasPrimary sarcomas of pancreas are rare and represent <0.1% of all primary pancreatic neoplasms. 1 They usually present as highgrade tumours with large sizes in the head of pancreas and are more common in females. 2 Herein, we present a case of a middleaged male with spindle cell neoplasm (SCN) of the pancreas.A 50-year male initially presented to an internist with occasional epigastric pain.Blood investigations were within normal range but the ultrasound of upper abdomen revealed a lobulated lesion arising from the head of the pancreas.Furthermore, CT scan showed heterogeneously enhancing lesion in the mesentery root.It had a central area of necrosis arising from the uncinate process of pancreas measuring 94 x 99 x 82 mm in anterior-posterior (AP), transverse (TR), and craniocaudal (CC) dimensions.The lesion was surrounded by fat stranding, which was abutting the third part of the duodenum, infiltrating and encasing the superior mesenteric artery and superior mesenteric vein with complete thrombosis.The patient underwent endoscopic ultrasound (EUS) and fine needle aspiration biopsy (FNAB).The histopathology was consistent with SCN, leiomyosarcoma grade II.Immunohistochemistry showed positive desmin, smooth muscle actin (SMA) and caldesmon, focal positive, p16, diffuse positive, and CD 34 patchy positive, whereas MDM2, CAM 5.2, Cytokeratin AE1/AE 3, CD117, DOG1, and S-100 were all negative.Mib-1 (Ki-67) index was high.Subsequently, a PET CT scan revealed large hyper--metabolic mass with central necrosis at the root of mesentery with few non-FDG-avid subcentimeter perilesional lymph nodes with no metastatic disease.It was planned to proceed with surgical removal of the primary tumour.
Author: Asif Husain Osmani
Institutions: Ziauddin Hospital, Ziauddin University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4401430906