title: Unusual early-stage pancreatic sarcomatoid carcinoma.
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.
authors.affiliation: Chuan-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.
authors.forename: Chuan-Li
authors.initials: CL
authors.lastname: Ren
authors.forename: Ping
authors.initials: P
authors.lastname: Jin
authors.forename: Chong-Xu
authors.initials: CX
authors.lastname: Han
authors.forename: Qin
authors.initials: Q
authors.lastname: Xiao
authors.forename: Dao-Rong
authors.initials: DR
authors.lastname: Wang
authors.forename: Lin
authors.initials: L
authors.lastname: Shi
authors.forename: Da-Xin
authors.initials: DX
authors.lastname: Wang
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D002296:Carcinosarcoma / Q000097:blood / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D058750:Epithelial-Mesenchymal Transition; D006801:Humans; D007150:Immunohistochemistry; D017370:Interleukin-11 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000097:blood / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D053773:Transforming Growth Factor beta1 / Q000097:blood; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; C508611:IL11 protein, human; D017370:Interleukin-11; C508960:TGFB1 protein, human; D053773:Transforming Growth Factor beta1
keywords: Epithelial-to mesenchymal transition; Interleukin-11; Sarcomatoid carcinoma of the pancreas; Transforming growth factorβ1; Vimentin