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- W2912331060 abstract "Carcinosarcoma's are uncommon neoplasms primarily located in the uterus. Pancreatic carcinosarcoma is a more rare entity, generally identified in the middle aged or elderly. Histologically, pancreatic carcinosarcoma is characterized by carcinomatous and sarcomatous components. A small number of pancreatic carcinosarcoma has been reported in literature; for which the diagnosis was made via surgery. Prognosis of pancreatic carcinosarcoma is poor with average survival of 6 months. A 69-year-old female presented with cough and chest pain. She underwent CT chest, revealing pericardial effusion, pleural effusion, and pulmonary nodules. With concern for malignancy, patient underwent CT abdomen/pelvis, revealing heterogeneously enhancing mass in the genu of the pancreas. Laboratory studies were significant for CA 19-9 of 13.5 U/L, CEA of 0.7 ng/mL, aspartate aminotransferase of 16 U/L, alanine aminotransferase of 19 U/L, alkaline phosphatase of 119 U/L, and total bilirubin of 0.6 mg/dL. She underwent upper endoscopy and endoscopic ultrasound (EUS). Gastroscopy revealed ulcerated gastric polyps that were biopsied with cold forceps. EUS demonstrated a hypoechoic mass in the pancreatic genu measuring 3.1 x 2 cm with abutment of the portal vein. Fine needle biopsy was performed with a 22-gauge biopsy needle (Sharkcore, Medtronic, Minneapolis, MN) via a trangastric approach. An enlarged lymph node was also biopsied in the peripancreatic region. Pancreatic mass biopsy revealed carcinosarcoma, with gastric polyp and peripancreatic lymph node biopsies revealing identical morphology. Patient was offered chemotherapy for treatment, but given poor prognosis, opted for hospice. This case is unique in that only approximately 20 cases of pancreatic carcinosarcoma have been reported in literature and all were diagnosed following surgical resection. To our knowledge, this is the first case of pancreatic carcinosarcoma being diagnosed by EUS guided core biopsy. Previous studies have demonstrated over 90% sensitivity for diagnostic yield with either a 22 or 25-gauge EUS guided core biopsy. This case demonstrates the rapidly emerging role and diagnostic ability for initial EUS guided biopsy for solid neoplasms in lieu of fine needle aspiration. It also reaffirms the importance of obtaining a histologic diagnosis prior to surgical resection or chemotherapy." @default.
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- W2912331060 date "2017-10-01" @default.
- W2912331060 modified "2023-09-25" @default.
- W2912331060 title "A Rare Pancreatic Mass Diagnosed by Endoscopic Ultrasound-Guided Biopsy" @default.
- W2912331060 doi "https://doi.org/10.14309/00000434-201710001-01341" @default.
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