title: Primary angiosarcoma of the pancreas mimicking severe acute pancreatitis--case report.
abstract: Primary angiosarcoma of the pancreas is an extremely rare neoplasm that often mimicks severe acute pancreatitis. A 58-year-old man was admitted with clinical and laboratory signs of severe acute pancreatitis. Contrast enhanced CT scan demonstrated haemorrhagic necrotizing inflammation of the pancreas involving the pancreatic tail, splenic hilum and small bowels with multiple peripancreatic and free abdominal fluid collection. Percutaneous drainage was performed. After 13 days, laparotomy was indicated because of persistent intra-abdominal bleeding, fever and a palpable, rapidly growing mass in the left upper quadrant of the abdomen. During the operation a necrotic, haemorrhagic mass was found in the pancreatic tail; a frozen section showed malignancy, although the tumour was unresectable. Despite all conservative and surgical therapeutic attempts, the patient died within four weeks after diagnosis. Final histology justified primary angiosarcoma of the pancreas. If a patient with signs of severe acute pancreatitis has fever without elevated PCT, the presence of a malignant tumour of the pancreas should be considered.
authors.affiliation: University of Debrecen, Medical and Health Science Center, Institute of Surgery, Hungary. Electronic address: csiszko@gmail.com.
authors.forename: Adrienn
authors.initials: A
authors.lastname: Csiszkó
authors.affiliation: University of Debrecen, Medical and Health Science Center, Department of Anaesthesiology and Intensive Care, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: László
authors.affiliation: University of Debrecen, Medical and Health Science Center, Department of Internal Medicine, Hungary.
authors.forename: Károly
authors.initials: K
authors.lastname: Palatka
authors.affiliation: University of Debrecen, Medical and Health Science Center, Institute of Surgery, Hungary.
authors.forename: Károly Gábor
authors.initials: KG
authors.lastname: Szabó
authors.affiliation: University of Debrecen, Medical and Health Science Center, Institute of Surgery, Hungary.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Kanyári
authors.affiliation: University of Debrecen, Medical and Health Science Center, Institute of Pathology, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Bidiga
authors.affiliation: University of Debrecen, Medical and Health Science Center, Institute of Pathology, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Csonka
authors.affiliation: University of Debrecen, Medical and Health Science Center, Institute of Surgery, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Damjanovich
authors.affiliation: University of Debrecen, Medical and Health Science Center, Institute of Surgery, Hungary.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Szentkereszty
mesh_terms: D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006394:Hemangiosarcoma / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis*
keywords: Acute necrotizing pancreatitis; Acute pancreatitis; Cancer of pancreas; Malignant mesenchymal tumour; Pancreas neoplasm; Sarcoma