Carcinosarcoma of the pancreas

A unique case with emphasis on metaplastic transformation and the presence of undifferentiated pleomorphic high-grade sarcoma

Hyunsoo Kim, Sun Hyung Joo, Dal Mo Yang, Sang Hyun Lee, Sung Ho Choi, Sung Jig Lim

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

We report a rare case of pancreatic carcinosarcoma in a 48-year-old man. An abdominal ultrasound scan incidentally detected a large heterogeneous mass in the left upper quadrant. CT and MRI scans indicated a rapidly growing unilocular cystic mass in the pancreatic tail. Grossly, the resected pancreatic mass measured 7×5×5 cm and consisted of a unilocular cystic lesion that had several solid mural nodules. Microscopically, the cystic wall showed two carcinomatous components, mucinous cystadenocarcinoma and anaplastic carcinoma. The solid lesion predominantly consisted of pleomorphic spindle cells arranged in interlacing fascicles which had infiltrated the adjacent pancreatic parenchyma. In some areas of this sarcomatous component, anaplastic carcinoma cells intermingled with or transformed into spindle cells. Immunohistochemically, the carcinomatous components were strongly positive for epithelial markers, and transforming anaplastic carcinoma cells were immunoreactive for both epithelial markers and vimentin; in contrast, the sarcomatous component was strongly positive for only vimentin. Additionally, an identical mutation (G to A transition) at codon 12 of K-ras gene and concordant immunoreactivity for p53 protein were detected in the carcinomatous and sarcomatous components. These findings suggested that the pancreatic carcinosarcoma could be of monoclonal origin, and that the sarcomatous component might have arisen from metaplastic transformation of the carcinomatous component.

Original languageEnglish
Pages (from-to)197-200
Number of pages4
JournalJournal of Gastrointestinal and Liver Diseases
Volume20
Issue number2
Publication statusPublished - 2011 Jun 1

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Carcinosarcoma
Sarcoma
Pancreas
Vimentin
Carcinoma
Neoplasms
Mucinous Cystadenocarcinoma
Mucinous Adenocarcinoma
ras Genes
Codon
Magnetic Resonance Imaging
Mutation
Proteins

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

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abstract = "We report a rare case of pancreatic carcinosarcoma in a 48-year-old man. An abdominal ultrasound scan incidentally detected a large heterogeneous mass in the left upper quadrant. CT and MRI scans indicated a rapidly growing unilocular cystic mass in the pancreatic tail. Grossly, the resected pancreatic mass measured 7×5×5 cm and consisted of a unilocular cystic lesion that had several solid mural nodules. Microscopically, the cystic wall showed two carcinomatous components, mucinous cystadenocarcinoma and anaplastic carcinoma. The solid lesion predominantly consisted of pleomorphic spindle cells arranged in interlacing fascicles which had infiltrated the adjacent pancreatic parenchyma. In some areas of this sarcomatous component, anaplastic carcinoma cells intermingled with or transformed into spindle cells. Immunohistochemically, the carcinomatous components were strongly positive for epithelial markers, and transforming anaplastic carcinoma cells were immunoreactive for both epithelial markers and vimentin; in contrast, the sarcomatous component was strongly positive for only vimentin. Additionally, an identical mutation (G to A transition) at codon 12 of K-ras gene and concordant immunoreactivity for p53 protein were detected in the carcinomatous and sarcomatous components. These findings suggested that the pancreatic carcinosarcoma could be of monoclonal origin, and that the sarcomatous component might have arisen from metaplastic transformation of the carcinomatous component.",
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Carcinosarcoma of the pancreas : A unique case with emphasis on metaplastic transformation and the presence of undifferentiated pleomorphic high-grade sarcoma. / Kim, Hyunsoo; Joo, Sun Hyung; Yang, Dal Mo; Lee, Sang Hyun; Choi, Sung Ho; Lim, Sung Jig.

In: Journal of Gastrointestinal and Liver Diseases, Vol. 20, No. 2, 01.06.2011, p. 197-200.

Research output: Contribution to journalArticle

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