A case of 18 years disease-free survival after combined pancreatoduodenectomy and hemicolectomy for carcinosarcoma of the transverse colon

Abstract

Background Ascertaining the origin of large tumors located in the region of the pancreas head and adjacent mesocolon can pose a challenge preoperatively. En bloc pancreatoduodenectomy with hemicolectomy is often required towards curative tumor resection (R0) of malignant tumors in this region. Case presentation Herein we report a case of a 48-year-old man with two contiguous masses each 5 cm in size, located in the pancreatic head. The masses were detected incidentally by abdominal ultrasonography at an annual health check. Endoscopic biopsies revealed inflammation with no malignancy. Cross-sectional imaging showed the tumor direct invasion of the uncinate process of the pancreas, and the third portion of the duodenum. Based on imaging, a malignant submucosal tumor originating from mesenchymal cells in the mesentery of the transverse colon was made preoperatively. The mass required en bloc pancreatoduodenectomy, right hemicolectomy, and resection of the superior mesenteric vein. The final pathology was carcinosarcoma of the transverse colon. The patient survived 18 years after surgery without recurrence. Conclusions Malignant tumors located in the region of the pancreas head should be considered for an en bloc curative tumor resection and adjuvant chemotherapy treatments offered that might be beneficial for carcinosarcoma.

Colorectal Carcinoma With Sarcomatoid Components

“…We identified 50 previously reported cases of CRC with sarcomatoid components in our literature review, nearly always under the moniker of either carcinosarcoma or sarcomatoid carcinoma 4–53 . These are summarized in Supplemental Table 1, Supplemental Digital Content 1, http://links.lww.com/PAS/B738, though most cases were not published in the pathology literature, various clinicopathologic details were not available for most cases, and a few cases were not published in English or were not accessible.…”

“…Carcinoma with sarcomatoid components is extremely rare, with ~50 reported cases 4–53 and one National Cancer Database search 54 previously published in the literature, the former exclusively as single-case reports. These publications usually employed the term “carcinosarcoma” or “sarcomatoid carcinoma,” with the specific term “carcinoma with sarcomatoid components” not used in the literature before the 2019 publication of the latest WHO classification.…”

Carcinosarcoma of the colon with extensive and extraordinary metastases detected on F-FDG18PET/CT: A case report

“…The median overall survival of patients was few months which confirms the poor prognosis of colorectal carcinosarcomas. Only 4 patients were alive 2 years after the initial surgery [ 4 ] although Susumu Ohwada et al reported a case of 18 years disease-free survival for carcinosarcoma of the transverse colon [ 12 ].…”