A Rare Case of Borderline Resectable Carcinosarcoma

  • Giovanni Taffurelli Department of Surgery, “S.Orsola-Malpighi” Hospital. Bologna, Italy
  • Marielda D’Ambra
  • Carlo Alberto Pacilio
  • Salvatore Buscemi
  • Eugenia Peri
  • Claudio Ricci
  • Donatella Santini
  • Raffaele Pezzilli
  • Riccardo Casadei Department of Surgery, “S.Orsola-Malpighi” Hospital. Bologna, Italy
  • Francesco Minni
Keywords: Meeting Abstracts, Pancreas


Context Carcinosarcomas are neoplasms with mixed carcinomatous and sarcomatous elements, which rarely occur in the pancreas. Case report A 62-year-old man was admitted to our institute for the presence of intense abdominal pain, worsening of a type II diabetes and weight loss (10 kg in 3 months). The tumor markers (CEA, CA 19-9) were within normal range. A CT scan showed a large pancreatic head solid mass of about 5 cm in diameter, with central necrotic area with septa, peripheral contrast-enhancement and compression and dislocation of the superior mesenteric vein for a tract of 2.5 cm (G3). An US-guided percutaneous biopsy diagnosed a malignant, high grade spindle cells neoplasia with immunophenotypic pattern of sarcomas. Surgical approach was planned and a total pancreatectomy with vascular resection was performed. The vascular resection included a 8 cm tract of portal-mesenteric trunk and the reconstruction was performed using a donor’s femoral vein homograft. Pathological examination of the specimen showed a solid mass of 6 cm in diameter, with infiltration of the portal vein. Lymph nodes (n=48) were negative and the surgical margins were tumor-free. Microscopically the tumor was characterized by high grade, polymorphous, intensely desmin-positive spindle cells mixed with areas of moderately differentiated ductal adenocarcinoma. The remaining pancreatic gland was interested by a diffuse lympho-plasmacellular GEL-type acute pancreatitis. A final diagnosis of carcinosarcoma, pT3N0M0, was performed. The postoperative course was uneventful and the patient was discharged in post-operative day 14th. He is dead, 4 months after surgery. Conclusion In literature only 10 cases of pancreatic carcinosarcomas have been described All cases were treated surgically and they showed a poor prognosis (average 6 months) and a rapid recurrence of the disease as in our case.


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How to Cite
TaffurelliG., D’AmbraM., PacilioC., BuscemiS., PeriE., RicciC., SantiniD., PezzilliR., CasadeiR., & MinniF. (2012). A Rare Case of Borderline Resectable Carcinosarcoma. JOP. Journal of the Pancreas, 13(5S), 640. https://doi.org/10.6092/1590-8577/1013

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