Pancreatic carcinosarcoma. Case report of multimodal therapy and review of the literature.
BACKGROUND
Carcinosarcoma (malignant mixed tumor) is a rare variant of a pancreatic neoplasm having a dismal prognosis; very few clinical data and treatment options have been published. Unlike adenocarcinoma of the pancreas, there is nothing specific in the literature for this variant regarding postoperative treatment with chemotherapeutic agents.


METHODS
We report the case of a 61-year-old woman presenting with anemia. Examination revealed a mass in the pancreatic head and she underwent a partial pancreaticoduodenectomy. Histopathological examination revealed a pancreatic neoplasm with both adenomatous as well as sarcomatous characteristics. Postoperatively, the patient was treated with gemcitabine and was in a good health for 9 months. Three follow-up CT scans were done, showing complete remission. Eleven months postoperatively, the patient died from a recurrence.


CONCLUSIONS
Carcinosarcoma of the pancreas is a very rare disease having a dismal prognosis. In addition to reviewing the literature on this entity, we present the first published case where gemcitabine was administered as a treatment modality in combination with surgery.
Gelos
Marcos
M
Department of General and Visceral Surgery, Augusta-Kranken-Anstalt, Bochum, Germany. gelos@augusta-bochum.de
Behringer
Dirk
D
Philippou
Stathis
S
Mann
Benno
B
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002296:Carcinosarcoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011379:Prognosis; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine