title: Preoperative diagnosis of pancreatic leiomyosarcoma.
abstract: BACKGROUND
  The low incidence of pancreatic leiomyosarcoma is responsible for the small number of cases correctly diagnosed preoperatively, the tumor being frequently confused with benign pancreatic lesions.
  
  
  RESULTS
  We describe a symptom free 52-yr-old male bearing an abdominal mass incidentally found at physical examination. Imaging techniques revealed a nonhomogenous large mass at the head of the pancreas that dislodged the portal vein and the superior mesenteric vein. Increased metabolic activity in the tumor area demonstrated by 18F-fluorodeoxyglicose positron emission tomography scan allowed the diagnosis of a malignant lesion. The patient was operated on and a pylorus preserving pancreatoduodenectomy performed. The pathology diagnosis was a low grade leiomyosarcoma. Immunohistochemistry revealed positivity for vimentin and smooth muscle specific actin. The clinical course was uneventful after 2 yr follow-up.
  
  
  CONCLUSIONS
  Pancreatic leiomyosarcoma may be preoperatively diagnosed by image techniques and differentiated from benign lesions by means of fluorodeoxyglicose positron emission tomography scanning (FDGPET).
authors: Department of Gastroenterology, School of Medicine, University of São Paulo, Brazil. mccm37@vol.com.br
authors: M C
authors: MC
authors: Machado
authors: J E
authors: JE
authors: Cunha
authors: S
authors: S
authors: Penteado
authors: T
authors: T
authors: Bacchella
authors: J
authors: J
authors: Jukemura
authors: A C
authors: AC
authors: Costa
authors: I
authors: I
authors: Halpern-Salomon
mesh_terms: D000199:Actins / Q000378:metabolism; D003937:Diagnosis, Differential; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014746:Vimentin / Q000378:metabolism
chemical_list: D000199:Actins; D014746:Vimentin; D019788:Fluorodeoxyglucose F18