2006 Volume 39 Issue 6 Pages 689-695
A 69-year-old man referred for upper abdominal pain and back pain was found in ultrasonography (US) to have a low echoic mass 1.6cm in diameter with hyperechoic spots inside the pancreatic body. Enhanced US showed a hypervascular tumor. Abdominal computer tomography (CT) showed a mass enhanced on the pancreatic body. Biopsy from the tumor revealed adenocarcinoma diagnosed as carcinoma of the pancreas necessitating distal pancreatectomy with splenectomy. Histological studies showed a tumor 1.5cm in diameter consisting of tubular adenocarcinoma and spindle cells. The definitive diagnosis was anaplastic spindle-cell carcinoma of the pancreas. Five months after the operation, recurrence was found in the left abdominal field and 1 month after that, a tumor was found at the ampulla of Vater. Biopsy from the tumor at the ampulla of Vater showed sarcomatous components. Liver metastasis also occurred, and the man died 8 months after the operation.
