title: A resected perivascular epithelioid cell tumor (PEComa) of the pancreas diagnosed using endoscopic ultrasound-guided fine-needle aspiration.
abstract: Primary perivascular epithelioid cell tumors (PEComas) of the pancreas are extremely rare. We herein report our experience with a patient who had a primary PEComa of the pancreas that was diagnosed by the preoperative histopathological examination of a biopsy specimen obtained by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The patient was a 43-year-old woman whose chief complaint was abdominal pain. Imaging studies revealed a pancreatic tumor. Gastrointestinal stromal tumor (GIST), solid pseudopapillary tumor and neuroendocrine tumor were considered in the differential diagnosis. A histopathological examination of a specimen of the tumor obtained using EUS-FNA showed spindle-shaped tumor cells with enlarged nuclei and eosinophilic cytoplasm. The tumor cells proliferated in a sheet-like fashion and stained positive for the melanoma-associated antigen HMB-45. A PEComa was thus diagnosed. If an adequate tumor specimen can be obtained using EUS-FNA, immunostaining may facilitate the diagnosis of extremely rare diseases and therefore assist in deciding the treatment policy.
authors.affiliation: Department of Gastroenterology, Kitasato University School of Medicine, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Okuwaki
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kida
authors.forename: Hironori
authors.initials: H
authors.lastname: Masutani
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamauchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Katagiri
authors.forename: Tetuo
authors.initials: T
authors.lastname: Mikami
authors.forename: Shiro
authors.initials: S
authors.lastname: Miyazawa
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Iwai
authors.forename: Miyoko
authors.initials: M
authors.lastname: Takezawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imaizumi
authors.forename: Wasaburo
authors.initials: W
authors.lastname: Koizumi
mesh_terms: D000328:Adult; D000792:Angiography; D002291:Carcinoma, Papillary / Q000175:diagnosis; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis; D006801:Humans; D007150:Immunohistochemistry; D058950:Melanoma-Specific Antigens / Q000378:metabolism; D018358:Neuroendocrine Tumors / Q000175:diagnosis; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D054973:Perivascular Epithelioid Cell Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D058951:gp100 Melanoma Antigen
chemical_list: D058950:Melanoma-Specific Antigens; C548637:PMEL protein, human; D058951:gp100 Melanoma Antigen