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Möller K, Ntovas S, Hocke M, On W, Everett SM, Braden B, Jenssen C, Misselwitz B, Ge N, Sun S, Gerber M, Faiss S, Dietrich CF. Comments and illustrations of the European Federation of Societies for Ultrasound in Medicine guidelines: Rare pancreatic tumors, ultrasound and contrast-enhanced ultrasound features-Malignant mesenchymal tumors. Endosc Ultrasound 2024; 13:55-64. [PMID: 38947746 PMCID: PMC11213603 DOI: 10.1097/eus.0000000000000054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Rare malignant mesenchymal pancreatic tumors are systematized and reported in this review. The focus is on the appearance on imaging. The present overview summarizes the data and shows that not every pancreatic tumor corresponds to the most common entities of ductal adenocarcinoma or neuroendocrine tumor.
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Affiliation(s)
- Kathleen Möller
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Sotirios Ntovas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Michael Hocke
- Medical Department II, Helios Klinikum Meiningen, Germany
| | - Wei On
- Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Simon M. Everett
- Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Barbara Braden
- Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, United Kingdom
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch-Oderland, Strausberg, Germany
- Brandenburg Institute for Clinical Ultrasound (BICUS) at Medical University Brandenburg, Neuruppin, Germany
| | - Benjamin Misselwitz
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nan Ge
- Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Siyu Sun
- Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Michael Gerber
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Siegbert Faiss
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Christoph F. Dietrich
- Department Allgemeine Innere Medizin der Kliniken (DAIM) Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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Wilson N, Issak A, Amin K, Tuttle TM, Trikudanathan G, Mallery S. Primary Pancreatic Liposarcoma: An Unexpected Cause of a Pancreatic Mass. ACG Case Rep J 2023; 10:e01242. [PMID: 38107608 PMCID: PMC10723886 DOI: 10.14309/crj.0000000000001242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/18/2023] [Indexed: 12/19/2023] Open
Abstract
Liposarcoma is the most common type of soft-tissue sarcoma and typically occurs in the extremities or retroperitoneum. Primary liposarcoma of the pancreas is exceedingly rare, with only 10 cases reported since 1979. We present a patient who was incidentally discovered to have a pancreatic mass on imaging, which was ultimately diagnosed as dedifferentiated pancreatic liposarcoma. We review the clinical and histologic features of pancreatic liposarcoma in this case and in the 10 previously reported cases to increase awareness and knowledge of this rare disease.
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Affiliation(s)
- Natalie Wilson
- Department of Internal Medicine, University of Minnesota Medical Center, Minneapolis, MN
| | - Abdulfatah Issak
- Department of Internal Medicine, University of Minnesota Medical Center, Minneapolis, MN
- Division of Gastroenterology and Hepatology, University of Minnesota Medical Center, Minneapolis, MN
| | - Khalid Amin
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical Center, Minneapolis, MN
| | - Todd M. Tuttle
- Department of Surgery, University of Minnesota Medical Center, Minneapolis, MN
| | - Guru Trikudanathan
- Department of Internal Medicine, University of Minnesota Medical Center, Minneapolis, MN
- Division of Gastroenterology and Hepatology, University of Minnesota Medical Center, Minneapolis, MN
| | - Shawn Mallery
- Department of Internal Medicine, University of Minnesota Medical Center, Minneapolis, MN
- Division of Gastroenterology and Hepatology, University of Minnesota Medical Center, Minneapolis, MN
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Retroperitoneal liposarcoma with pancreatic metastasis and gastric cancer: a case report. Clin J Gastroenterol 2022; 16:164-170. [PMID: 36534319 DOI: 10.1007/s12328-022-01742-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022]
Abstract
On computed tomography scanning, a 63-year-old man with vomiting and anorexia was discovered to have a mass in the pancreatic body and a retroperitoneal mass extending to the right lobe of the liver. An esophagogastroduodenoscopy revealed an advanced gastric carcinoma in the middle gastric body, and a biopsy specimen revealed a poorly differentiated adenocarcinoma. The pancreatic and retroperitoneal masses were considered metastatic lesions of gastric cancer, and a biopsy was taken from the pancreatic lesion using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The histology of the EUS-FNA pancreatic specimen revealed atypical spindle-shaped cells and increased stromal collagen fibrosis, and liposarcoma was considered. Conversely, a percutaneous ultrasound-guided biopsy was taken for the retroperitoneal lesion, and the histology revealed that it was a dedifferentiated liposarcoma. On the basis of histopathological and imaging findings, the retroperitoneal liposarcoma was identified as the primary lesion, the pancreatic lesion as a metastasis of the primary liposarcoma, and the gastric carcinoma as an independent tumor. As far as we know, there have only been three reports of metastatic pancreatic liposarcoma diagnosed via EUS-FNA. In this case, the patient also had gastric cancer, and EUS-FNA was helpful in differentiating metastatic pancreatic tumors from gastric cancer.
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Tanabe M, Matsui H, Higashi M, Tokumitsu Y, Nagano H, Ito K. Pancreatic liposarcoma: a case report. Abdom Radiol (NY) 2022; 47:1912-1916. [PMID: 35507066 DOI: 10.1007/s00261-022-03522-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 11/09/2022]
Abstract
An 81-year-old woman who had undergone total thyroidectomy for papillary thyroid cancer 12 years earlier was found to have a tumor in the tail of the pancreas. Four years earlier, skin, lung, and mediastinal lymph node metastases had appeared. Computed tomography (CT) showed a mass 26 mm in diameter in the tail of the pancreas. Thereafter, the pancreatic tumor increased in size, while the lung metastases remained stable. Unenhanced CT at the time of first detection showed that the tumor was heterogeneous, with low-attenuation areas indicating fat components. As the tumor grew, the fat components became unclear. Laparoscopic distal pancreatectomy and splenectomy were performed. The tumor was diagnosed as dedifferentiated liposarcoma with a well-differentiated liposarcoma component at the tumor margin. The pancreas is an extremely rare site of primary liposarcoma. In the present case, a pancreatic liposarcoma appeared during follow-up of thyroid cancer, and the changes over time were able to be observed with CT.
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Tee CL, Lin EY, Bundele MM, Low JK. Rare case of pancreatic lipomatous hamartoma. BMJ Case Rep 2022; 15:e248132. [PMID: 35393275 PMCID: PMC8990702 DOI: 10.1136/bcr-2021-248132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/09/2022] Open
Abstract
A middle-aged man had an incidental finding of 10.1 cm lipomatous mass arising from pancreatic body/neck detected on CT scan. He was asymptomatic. He underwent surgical resection of the mass due to concern for malignancy. His postoperative course was complicated by a high-volume pancreatic leak of approximately 900 mL/day. He underwent endoscopic retrograde cholangiopancreatography and insertion of a pancreatic stent, with some improvement in the pancreatic leak. His leak eventually settled after 3 months. The final histopathology showed lobules of mature adipocytes with small islands of disorganised benign pancreatic ducts and acini interspersed within them, suggestive of pancreatic hamartoma of lipomatous variant. Pancreatic lipomatous hamartomas are rare and are often diagnosed on final histopathology when the initial resection was performed due to diagnostic uncertainty or concern for malignancy. It is a benign lesion with an indolent course and must be discriminated from other lipomatous lesions of the pancreas. An awareness of the condition is important to help guide management.
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Affiliation(s)
- Chin Li Tee
- Department of Hepato-Pancreatico-Biliary Surgery, Tan Tock Seng Hospital, Singapore
| | - Eliz Yuyuan Lin
- Department of Hepato-Pancreatico-Biliary Surgery, Tan Tock Seng Hospital, Singapore
| | | | - Jee Keem Low
- Department of Hepato-Pancreatico-Biliary Surgery, Tan Tock Seng Hospital, Singapore
- Department of Hepato-Pancreatico-Biliary Surgery, Tan Tock Seng Hospital, Singapore
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