Case Report: Synchronous pancreatic sarcomatoid carcinoma and gastric cancer: a case study with literature review

TL;DR

This case report describes a rare instance of a 69-year-old woman diagnosed with two cancers at once—pancreatic sarcomatoid carcinoma and gastric cancer—and discusses the challenges of treating such a rare condition.

Contribution

This is the first reported case of synchronous pancreatic sarcomatoid carcinoma and gastric cancer, providing new clinical insights.

Findings

The patient had a gastric adenocarcinoma and a pancreatic sarcomatoid carcinoma with low-grade adenocarcinoma components.

Postoperative tumor markers decreased but remained elevated, and the patient developed liver metastases and died within 107 days.

Surgical treatment was attempted, but the prognosis remained poor despite supportive care.

Abstract

To illuminate the pathological characteristics and treatment of synchronous pancreatic sarcomatoid carcinoma(SCP) and gastric cancer using a case report and comprehensive literature review.

Clinical presentation, pathological findings and immunohistochemical results of a patient with SCP and gastric cancer were reviewed. A surgical treatment strategy with best supportive care, including nutrition support, was adopted. A comprehensive literature review was conducted.

A 69-year-old female patient presented to the general surgery clinic with ten days of abdominal pain. A Type IIc lesion measuring 30 mm in diameter was found in the gastric angle. Additionally,a thick-walled, solid mass with dimensions of 33 mm by 30 mm was detected in the pancreatic tail. HE staining revealed a moderately to poorly differentiated adenocarcinoma and partial mucinous adenocarcinoma in gastric angle and a sarcomatoid carcinoma with low-grade adenocarcinoma components in pancreatic tail. Immunohistochemical assay of the mass in pancreatic tail showed partial positivity for CK(pan), CK7, CD56, CD138, CEA, EMA, and Ki-67 (60%). The patient’s serum levels of CA199, CEA, CA125, and CA242 were sharply decreased postoperatively but remained above normal limits. However, these markers were predominantly increased in the presence of multiple liver metastases.Malnutrition and progressive disease occurred despite the adoption of EN plus PN and best supportive care, and the patient died on postoperative day 107.

Synchronous SCP and gastric cancer are first reported in this study. Surgical treatment remains effective despite an even poorer prognosis.

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