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World J Gastroenterol. 2013 Nov 21;19(43):7820-4. doi: 10.3748/wjg.v19.i43.7820.

Unusual early-stage pancreatic sarcomatoid carcinoma.

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  • 1Chuan-Li Ren, Ping Jin, Chong-Xu Han, Laboratory Medicine and Pathology Department, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China.

Abstract

Sarcomatoid carcinoma of the pancreas (SCP) is a very rare pathological type of carcinoma that usually has a poor prognosis. Its pathogenesis has not been elucidated. We herein report a case of an early-stage SCP involving successful treatment and a good prognosis. The patient was a 48-year-old Chinese man with a 5-mo history of vague abdominal pain. Ultrasonography revealed a 93 mm × 94 mm × 75 mm mass of mixed echogenicity in the tail of the pancreas. Laboratory test results were within the normal range, with the exception of an obviously increased pretreatment neuron-specific enolase level. The plasma transforming growth factor (TGF)β1 and interleukin-11 levels were obviously increased according to enzyme-linked immunosorbent assay. Microscopically, the excised tumor tissue comprised cancer cells and mesenchymal cells. Immunohistochemical analysis was positive for α-1-antichymotrypsin, pan-cytokeratin, cytokeratin 19, cytokeratin 8/18, and vimentin and negative for CD68 and lysozyme. The pathogenetic mechanism of this case shows that TGFβ1 may regulate the epithelial-to-mesenchymal transition in SCP. With early eradication of the tumor and systemic therapy, this patient has been alive for more than 3 years without tumor recurrence or distant metastasis. This case is also the first to show that TGFβ1 may regulate the epithelial-to-mesenchymal transition in early-stage SCP.

KEYWORDS:

Epithelial-to mesenchymal transition; Interleukin-11; Sarcomatoid carcinoma of the pancreas; Transforming growth factorβ1; Vimentin

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