1996 Volume 57 Issue 11 Pages 2788-2792
A 66-year-old man with leiomyosarcoma of the pancreas is reported. The patient was admitted to the hospital because of an epigastralgia. A hypervascular cystic tumor of the pancreas was suspected by CT, ultrasonography and angiography. Laparotomy was performed and a 7×6cm cystic tumor was found at the pancreas body and tail. The tumor invaded the posterior wall of the stomach. Multiple metastasis of the liver was present. Distal pancreatectomy was carried out, and the opertion was absolute non-curative. Pathological examination revealed leiomyosarcoma of the pancreas and its metastasis of the liver. On 11th operative day, the patients went into a shock condition due to the hemoperitoneum, and hemostasis, gastrostomy and cholecystostomy were emergently performed. The hemorrhage from the inferior pancreatoduodenal artery due to invasion of the remnant tumor was revealed. The patient died of multiple organ failure on the 35th postoperative day. Autopsy revealed metastasis of the bilateral kidneys, peritoneum, left hilus pulmonis and bone marrows (L4, S1, S3).
Leiomyosacoma of the pancreas is very rare. Only 26 cases have been reported in world literature. On differential diagnosis of cystic and hypervascular tumors of the pancreas, leiomyosarcoma which is a cystic and moderately hypervascular tumor should be entertained as a probable diagnosis.
