Rare pancreatic carcinosarcoma in a patient with medical history of esophageal cancer

Abstract

Rationale: Pancreatic carcinosarcoma (PCS) is a very rare pancreatic cancer with an extremely poor prognosis. Interestingly, PCS can coexist with other metachronous malignant cancers. Here we report a case of PCS combined with esophageal cancer (EC). Patient concerns: The patient was a 66-year-old man who presented with abdominal pain and progressive nausea. He had undergone esophagectomy for EC 5 years previously. Diagnosis: Both EC and PCS were confirmed via postoperative pathological diagnosis. Interventions: Owing to the patient's previous esophagectomy for EC, pancreaticoduodenectomy for the PCS could not be performed. Instead, he underwent cholecystectomy with bile duct-jejunum Roux-en-Y anastomosis and radioactive seed implantation. Outcomes: The patient is still alive for >1 year. Lessons: To our knowledge, this is the first report of PCS combined with EC and thus of metachronous multiple primary carcinoma. A detailed literature review of the clinical and histologic features of PCS reveals important information about the epidemiology and biology of this rare disease.

Collective review of pancreatic carcinosarcoma, a very rare pancreatic malignancy

“…For literature review through PubMed, we were able to review reports on 48 patients within 33 available papers, including our case ( Table 1 ) [ 3 - 10 , 12 - 35 ]. Most of these included papers were case reports.…”

A Case Report on Carcinosarcoma of the Pancreas with a Concise Literature Review

“…18 The overall survival has a mean of 15 months and 14 days in 25 cases (Table 2). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]…”

“…In several cases, a specific diagnosis is rendered: Malignant fibrous histiocytoma / Undifferentiated Pleomorphic Sarcoma / Pleomorphic Spindle Cell Sarcoma (MFH/UPS/PSCS) (27%), MFH/UPS with Osteosarcoma (13%), Leiomyosarcoma (3%), Osteosarcoma (7%) and Embryonal Rhabdomyosarcoma (3%) (Table 2). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Immunohistochemistry with Pancytokeratin and Vimentin demonstrated the distinction between the epithelial and mesenchymal components. The other epithelial markers with positive expression are CAM 5.2, Epithelial Membrane Antigen (EMA), Carcinoembryonic Antigen (CEA), Cytokeratin 7 (CK7), and Cytokeratin 19 (CK19).…”

Sarcomatoid carcinoma of the pancreas — multimodality imaging findings with serial imaging follow-up: A case report and review of literature

“…Despite the development of chemotherapy, PSC shows multiple metastases and disease recurrence. Fortunately, recent case reports have described a long-term survival of more than one year following surgery[ 14 - 20 ]. Therefore, despite challenges in obtaining a definitive preoperative diagnosis, an accurate and early diagnosis is important for active and appropriate treatment.…”