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Clinicopathologic features of two rare cases of mesenchymal metastatic
tumors in the pancreas: review of the literature.Pancreas.
2006 Oct;33(3): 301-3.
OBJECTIVES: A
clinicopathologic presentation of 2 unusual cases of metastatic
mesenchymal neoplasms in the pancreas. METHODS: The first case
concerns a 26-year-old man with a history of intracranial mesenchymal
chondrosarcoma (since the age of 17), 2 left lung operations, and 3
right thigh operations. Distal pancreatectomy and splenectomy was
performed because of suspicious mass in the pancreas. The second case
concerns a 66-year-old woman with a history of uterus leiomyosarcoma
(10 years ago) with left axillary and right femoral metastases. She
underwent distal pancreatectomy and splenectomy because of suspicious
mass measuring 4 x 4 cm, in the pancreatic body. RESULTS: In the first
case, the pathological examination revealed a tumor measuring 3.8 x
3.5 cm and histologically compatible with mesenchymal chondrosarcoma,
developing in a vessel lumen and invading into the pancreatic
parenchyma. In the second case, the pathological examination showed
metastatic leiomyosarcoma of high-grade malignancy. The incidence of
metastatic pancreatic tumors has been reported to be only 1.6% to 3%.
Most of these tumors were of epithelial origin, and the most common
sites of the primary lesions were the lung, kidney, and
gastrointestinal tract. CONCLUSIONS: The cases of metastatic uterus
leiomyosarcoma and the metastatic intracranial chondrosarcoma are, to
our knowledge, the first to be described.
Mesenchymal
tumors of the pancreas: computed tomography patterns. Radiol
Med (Torino). 1999 Oct;98(4):295-9.
PURPOSE: To
report the CT patterns of pancreatic mesenchymal lesions and to
investigate the capabilities and limitations of this technique in
terms of characterization. MATERIAL AND METHODS: We selected the CT
examinations of 23 patients from all CT examinations of the pancreas
performed from 1986 to 1998. The patients were 10 to 85 years old and
all lesions but two (1 lipoma and 1 lymphoma) had pathologic
confirmation. Two lymphangiomas, 2 lipomas, 4 Schwannomas (SCH), 1
plexiform neurofibroma, 1 cystic teratoma, 1 pancreatoblastoma, 9
non-Hodgkin's lymphomas (NHL), 1 undifferentiated sarcoma and 2
leiomyosarcomas were diagnosed. RESULTS: Lipomas had typically
homogeneous negative HU values, and NHL a homogeneous hypodense
pattern with mild contrast enhancement, with no necrosis or
calcifications in both diffuse and nodular forms; SCH had variable
appearance, with water/slightly negative HU numbers or highly enhanced
patterns with a central necrotic core depending on the main Antoni A
or B histology. Lymphangiomas appeared as complex cysts, with thin and
regular or calcified walls and intracystic septa, while the plexiform
neurofibroma had near-water homogeneous density with mild contrast
enhancement and an infiltrating growth pattern. Our teratoma had
multiple calcifications, mucinous and lipid components. The
pancreatoblastoma, sarcomas, and leiomyosarcomas exhibited no specific
findings. CONCLUSIONS: In selected cases, CT can provide virtually
diagnostic information (lipoma and teratoma), or at least highly
suggestive findings (NHL, plexiform neurofibroma, lymphangioma).
Moreover, knowledge of the variable morphostructural patterns of
mesenchymal histotypes (SCH, sarcoma etc.) permits to include them in
the differential diagnosis of pancreatic masses.
Malignant
non-epithelial tumors of the pancreas.Pathologe.
1997 May; 18(3): 233-7.
Nonepithelial
malignant tumors of the pancreas are extremely rare neoplasms with a
frequency of approximately 0.6%. They are always explored because of a
suspected diagnosis of pancreatic carcinoma. Amongst the more than 600
primary pancreatic neoplasms in our pancreatic tumor archive only 5
neoplasms were of nonepithelial origin (one was a malignant peripheral
nerve sheath tumor [MPNST], one a leiomyosarcoma, one a malignant
mesothelioma, and two were peripheral neuroectodermal tumors [PNET].
The differential diagnosis includes secondary infiltration of the
pancreas by mesenchymal tumors of the retroperitoneum,
undifferentiated pancreatic carcinoma and, especially in the case of
PNET, malignant lymphoma. Preoperative chemotherapy and down-staging
can improve the operability and prognosis, especially in PNET.
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