{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T07:05:40Z","timestamp":1779606340717,"version":"3.53.1"},"reference-count":13,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Case Rep"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Primary pancreatic leiomyosarcoma (PLMS) is a rare malignant tumor accounting for less than 0.1% of all pancreatic neoplasms and often presents at an advanced stage with distant metastases or local invasion. Clinical symptoms are nonspecific, including gastrointestinal discomfort, abdominal pain, or distension, which frequently leads to delayed diagnosis. We report a 53-year-old woman with persistent abdominal distension, bloating, and central discomfort, in whom imaging revealed a 7.5\u2009cm mass in the pancreatic tail with multiple liver metastases, encasement of the splenic arteries, and no direct invasion of the spleen or adjacent adrenal gland; her family history was notable for hematological, breast, and pancreatic cancers. Due to its rarity, aggressive metastatic behavior, and lack of standardized therapy, PLMS presents significant diagnostic and treatment challenges. This case highlights the importance of recognizing pancreatic leiomyosarcoma as a distinct clinical entity and contributes to the limited literature guiding its management.<\/jats:p>","DOI":"10.1177\/11795476261452331","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T12:40:16Z","timestamp":1779367216000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pancreatic Tail Leiomyosarcoma With Hepatic Metastases: Diagnostic and Therapeutic Challenges: A Case Report"],"prefix":"10.1177","volume":"19","author":[{"given":"Somaya","family":"Al Kiswani","sequence":"first","affiliation":[{"name":"Radiology Department, King Hussein Cancer Center, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nid\u2019a","family":"Mubarak","sequence":"additional","affiliation":[{"name":"Radiology Department, King Hussein Cancer Center, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renad","family":"Abu Ruman","sequence":"additional","affiliation":[{"name":"Radiology Department, King Hussein Cancer Center, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muna","family":"Shahwan","sequence":"additional","affiliation":[{"name":"Department of Medicine, An Najah National University, Nablus, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahaf","family":"Zorba","sequence":"additional","affiliation":[{"name":"Department of Medicine, An Najah National University, Nablus, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaimaa","family":"Abu Laban","sequence":"additional","affiliation":[{"name":"Department of Medicine, An Najah National University, Nablus, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5825-1092","authenticated-orcid":false,"given":"Omar","family":"Sawafta","sequence":"additional","affiliation":[{"name":"Department of Medicine, An Najah National University, Nablus, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Nofal","sequence":"additional","affiliation":[{"name":"Radiology Department, King Hussein Cancer Center, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181f97727"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"Fadaee N Sefa T Das A Rajkomar K. Pancreatic leiomyosarcoma: a diagnostic challenge and literature review. BMJ Case Rep. 2019;12(11):e231529. https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6887380\/","DOI":"10.1136\/bcr-2019-231529"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","unstructured":"Willems P Krall K Varadarajulu S. Primary leiomyosarcoma of the pancreas with metastasis to the spleen. VideoGIE. 2023;8(7):272-273. https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10339009\/","DOI":"10.1016\/j.vgie.2023.03.003"},{"key":"e_1_3_2_5_2","first-page":"10912","article-title":"Primary pancreatic leiomyosarcoma initially misdiagnosed as pancreatic adenocarcinoma: a case report and review of the literature","volume":"12","author":"Han L","year":"2019","unstructured":"Han L, Chen Y, Cui K, et al. Primary pancreatic leiomyosarcoma initially misdiagnosed as pancreatic adenocarcinoma: a case report and review of the literature. 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Hepatogastroenterology. 2012;59(120):2644-2649.","journal-title":"Hepatogastroenterology"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40792-015-0097-2"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diii.2016.07.013"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.6564"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12029-016-9872-y"},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","unstructured":"Alnaqbi S Kumar P Bin Sumaida A Shanbhag NM Ahmad AZ Balaraj K. Pancreatic leiomyosarcoma with multi-organ metastases: a rare case. Cureus. 2024;16(10):e52020. https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11600098\/","DOI":"10.7759\/cureus.72520"},{"key":"e_1_3_2_14_2","doi-asserted-by":"crossref","unstructured":"Muhammad SU Azam F Zuzana S. Primary pancreatic leiomyosarcoma: a case report. 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