{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T13:31:30Z","timestamp":1758634290477,"version":"3.37.3"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T00:00:00Z","timestamp":1590364800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T00:00:00Z","timestamp":1590364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Sarcomatoid carcinoma of the pancreas (SCP) tends to have similar or even worse prognosis than that of conventional pancreatic ductal adenocarcinoma. The clinical and pathological features of SCP remain poorly characterized owing to its rarity.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 58-year-old man was admitted to our hospital with the chief complaints of upper abdominal pain and weight loss. Abdominal contrast computed tomography revealed a 5-cm low-density mass in the pancreatic body. Magnetic resonance cholangiopancreatography revealed an obstruction of the main pancreatic duct and a dilation of the distal main pancreatic duct. Based on the clinicoradiological findings, pancreatic body cancer was suspected, and the distal pancreatectomy was performed. A pathological examination revealed that the tumor was composed of an area of invasive ductal adenocarcinoma and an area of sarcomatous spindle-shaped cells; the latter component predominated. The spindle cells were immunohistochemically positive for both cytokeratin and vimentin, and thus, a pathological diagnosis of SCP was made. In addition, immunohistochemical analysis suggested the sarcomatous component might be derived from the adenocarcinoma component via the process of epithelial-mesenchymal transition. After the operation, the patient received 6\u2009months of chemotherapy with gemcitabine. At 10\u2009years after the operation, the patient is alive with no recurrence.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The current case study presented a SCP patient with long-term survival after the operation. It was worth noting that the sarcomatous component of the tumor pathologically showed lower MIB-1 labeling index compared with those in previously reported SCP cases, which might account for the long-term survival of the patient.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12957-020-01879-8","type":"journal-article","created":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T15:03:41Z","timestamp":1590419021000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Sarcomatoid carcinoma of the pancreas with rare long-term survival: a case report"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2458-5985","authenticated-orcid":false,"given":"Toshihisa","family":"Kimura","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Fujimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamotsu","family":"Togawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Iida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasunori","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Goi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,5,25]]},"reference":[{"key":"1879_CR1","first-page":"295","volume-title":"World Health Organization Classification of Tumours, Digestive System Tumours, 5th edn","author":"AJ Gill","year":"2019","unstructured":"Gill AJ, Klimstra DS, Lam AK, Washington MK. Tumours of the pancreas. In: Lokuhetty D, White VA, Watanabe R, Cree IA, editors. World Health Organization Classification of Tumours, Digestive System Tumours, 5th edn. Lyon.: IARC; 2019. p. 295\u2013372."},{"key":"1879_CR2","first-page":"306","volume":"40","author":"KH Kim","year":"2006","unstructured":"Kim KH, Kang DY, Lee MK, Yang HW, Han HY. Sarcomatoid carcinoma of the pancreas. Kor J Pathol. 2006;40:306\u201310.","journal-title":"Kor J Pathol"},{"key":"1879_CR3","doi-asserted-by":"publisher","first-page":"7820","DOI":"10.3748\/wjg.v19.i43.7820","volume":"19","author":"CL Ren","year":"2013","unstructured":"Ren CL, Jin P, Han CX, Xiao Q, Wang DR, Shi L, Wang DX, Chen H. Unusual early-stage pancreatic sarcomatoid carcinoma. World J Gastroenterol. 2013;19:7820\u20134.","journal-title":"World J Gastroenterol"},{"key":"1879_CR4","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1046\/j.1440-1827.1999.00877.x","volume":"49","author":"M Higashi","year":"1999","unstructured":"Higashi M, Takao S, Sato E. Sarcomatoid carcinoma of the pancreas: a case report with immunohistochemical study. Pathol Int. 1999;49:453\u20136.","journal-title":"Pathol Int"},{"key":"1879_CR5","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1016\/j.gie.2006.06.004","volume":"64","author":"S De la Riva","year":"2006","unstructured":"De la Riva S, Mu\u00f1oz-Navas MA, Bet\u00e9s M, S\u00fabtil JC, Carretero C, Sola JJ. Sarcomatoid carcinoma of the pancreas and congenital choledochal cyst. Gastrointest Endosc. 2006;64:1005\u20136.","journal-title":"Gastrointest Endosc"},{"key":"1879_CR6","doi-asserted-by":"publisher","first-page":"568","DOI":"10.3892\/ol.2013.1411","volume":"6","author":"J Yao","year":"2013","unstructured":"Yao J, Qian JJ, Zhu CR, Bai DS, Miao Y. Laparoscopic left pancreatectomy for pancreatic sarcomatoid carcinoma: a case report and review of the literature. Oncol Lett. 2013;6:568\u201370.","journal-title":"Oncol Lett"},{"key":"1879_CR7","doi-asserted-by":"publisher","first-page":"245","DOI":"10.3892\/ol.2013.1683","volume":"7","author":"JR Kane","year":"2014","unstructured":"Kane JR, Laskin WB, MatkowskyJ KA, Villa C, Yeldandi AV. Sarcomatoid (spindle cell) carcinoma of the pancreas: a case report and review of the literature. Oncol Lett. 2014;7:245\u20139.","journal-title":"Oncol Lett"},{"key":"1879_CR8","first-page":"1","volume":"1","author":"RK Nambiar","year":"2017","unstructured":"Nambiar RK, Roshni S, Lijeesh AL, Mony RP. Sarcomatoid carcinoma of pancreas with liver metastases: a case report with review of literature. Journal of Medicine and Therapeutics. 2017;1:1\u20133.","journal-title":"Journal of Medicine and Therapeutics"},{"key":"1879_CR9","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1016\/j.jss.2017.05.065","volume":"219","author":"AB Blair","year":"2017","unstructured":"Blair AB, Burkhart RA, Griffin JF, Miller JA, Weiss MJ, Cameron JL, Wolfgang CL, He J. Long-term survival after resection of sarcomatoid carcinoma of the pancreas: an updated experience. J Surg Res. 2017;219:238\u201343.","journal-title":"J Surg Res"},{"key":"1879_CR10","first-page":"4716","volume":"18","author":"Y Xie","year":"2018","unstructured":"Xie Y, Xiang Y, Zhang D, Yao X, Sheng J, Yang Y, Zhang X. Sarcomatoid carcinoma of the pancreas: a case report and review of the literature. Mol Med Rep. 2018;18:4716\u201324.","journal-title":"Mol Med Rep"},{"key":"1879_CR11","doi-asserted-by":"publisher","first-page":"236","DOI":"10.12998\/wjcc.v7.i2.236","volume":"7","author":"DK Zhou","year":"2019","unstructured":"Zhou DK, Gao BQ, Zhang W, Qian XH, Wang WL. Sarcomatoid carcinoma of the pancreas: a case report. World Journal of Clinical Cases. 2019;7:236\u201341.","journal-title":"World Journal of Clinical Cases"},{"key":"1879_CR12","doi-asserted-by":"publisher","first-page":"597","DOI":"10.12659\/AJCR.915334","volume":"20","author":"N Bukhari","year":"2019","unstructured":"Bukhari N, Joudeh A. Early stage anaplastic sarcomatoid carcinoma of the pancreas, a case report. Am J Case Rep. 2019;20:597\u2013601.","journal-title":"Am J Case Rep"},{"key":"1879_CR13","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1111\/cas.12630","volume":"106","author":"M Saitoh","year":"2015","unstructured":"Saitoh M. Epithelial-mesenchymal transition is regulated at post-transcriptional levels by transforming growth factor-\u03b2 signaling during tumor progression. Cancer Sci. 2015;106:481\u20138.","journal-title":"Cancer Sci"},{"key":"1879_CR14","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1038\/nrgastro.2010.188","volume":"8","author":"Z Wang","year":"2011","unstructured":"Wang Z, Li Y, Ahmad A, Banerjee S, Azmi AS, Kong D, Sarkar FH. Pancreatic cancer: understanding and overcoming chemoresistance. Nat Rev Gastroenterol Hepatol. 2011;8:27\u201333.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"1879_CR15","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.pathol.2019.02.001","volume":"51","author":"HC Lien","year":"2019","unstructured":"Lien HC, Lee YH, Juang YL, Lu YT. Fibrillin-1, a novel TGF-beta-induced factor, is preferentially expressed in metaplastic carcinoma with spindle sarcomatous metaplasia. Pathology. 2019;51:375\u201383.","journal-title":"Pathology."},{"key":"1879_CR16","first-page":"132","volume":"115","author":"JM Millis","year":"1994","unstructured":"Millis JM, Chang B, Zinner MJ, Barsky SH. Malignant mixed tumor (carcinosarcoma) of the pancreas: a case report supporting organ-induced differentiation of malignancy. Surgery. 1994;115:132\u20137.","journal-title":"Surgery."},{"key":"1879_CR17","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1097\/00006676-199708000-00013","volume":"15","author":"M Watanabe","year":"1997","unstructured":"Watanabe M, Miura H, Inoue H, Uzuki M, Noda Y, Fujita N, Yamazaki T, Sawai T. Mixed osteoclastic\/pleomorphic-type giant cell tumor of the pancreas with ductal adenocarcinoma: histochemical and immunohistochemical study with review of the literature. Pancreas. 1997;15:201\u20138.","journal-title":"Pancreas."},{"key":"1879_CR18","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1097\/00000478-199701000-00008","volume":"21","author":"BM Wenig","year":"1997","unstructured":"Wenig BM, Albores-Saavedra J, Buetow PC, Heffess CS. Pancreatic mucinous cystic neoplasm with sarcomatous stroma: a report of three cases. Am J Surg Pathol. 1997;21:70\u201380.","journal-title":"Am J Surg Pathol"},{"key":"1879_CR19","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.5858\/2002-126-1114-COTP","volume":"126","author":"F Darvishian","year":"2002","unstructured":"Darvishian F, Sullivan J, Teichberg S, Basham K. Carcinosarcoma of the pancreas: a case report and review of the literature. Arch Pathol Lab Med. 2002;126:1114\u20137.","journal-title":"Arch Pathol Lab Med"},{"key":"1879_CR20","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1097\/01.mpa.0000178283.96276.8a","volume":"31","author":"SA Barkatullah","year":"2005","unstructured":"Barkatullah SA, Deziel DJ, Jakate SM, Kluskens L, Komanduri S. Pancreatic carcinosarcoma with unique triphasic histological pattern. Pancreas. 2005;31:291\u20132.","journal-title":"Pancreas."},{"key":"1879_CR21","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1177\/000313480607200416","volume":"72","author":"M Bloomston","year":"2006","unstructured":"Bloomston M, Chanona-Vilchis J, Ellison EC, Ramirez NC, Frankel WL. Carcinosarcoma of the pancreas arising in a mucinous cystic neoplasm. Am Surg. 2006;72:351\u20135.","journal-title":"Am Surg"},{"key":"1879_CR22","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1111\/j.1440-1827.2008.02289.x","volume":"58","author":"T Nakano","year":"2008","unstructured":"Nakano T, Sonobe H, Usui T, Yamanaka K, Ishizuka T, Nishimura E, Hanazaki K. Immunohistochemistry and K-ras sequence of pancreatic carcinosarcoma. Pathol Int. 2008;58:672\u20137.","journal-title":"Pathol Int"},{"key":"1879_CR23","first-page":"50","volume":"9","author":"M Gelos","year":"2008","unstructured":"Gelos M, Behringer D, Philippou S, Mann B. Pancreatic carcinosarcoma. Case report of multimodal therapy and review of the literature. JOP. 2008;9:50\u20135.","journal-title":"JOP."},{"key":"1879_CR24","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1111\/j.1365-2354.2008.00977.x","volume":"19","author":"ZL Shen","year":"2010","unstructured":"Shen ZL, Wang S, Ye YJ, Wang YL, Sun KK, Yang XD, Jiang KW. Carcinosarcoma of pancreas with liver metastasis combined with gastrointestinal stromal tumour of the stomach: is there a good prognosis with the complete resection? Eur J Cancer Care (Engl). 2010;19:118\u201323.","journal-title":"Eur J Cancer Care (Engl)"},{"key":"1879_CR25","first-page":"197","volume":"20","author":"HS Kim","year":"2011","unstructured":"Kim HS, Joo SH, Yang DM, Lee SH, Choi SH, Lim SJ. Carcinosarcoma of the pancreas: a unique case with emphasis on metaplastic transformation and the presence of undifferentiated pleomorphic high-grade sarcoma. J Gastrointestin Liver Dis. 2011;20:197\u2013200.","journal-title":"J Gastrointestin Liver Dis"},{"key":"1879_CR26","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1007\/s12032-010-9804-9","volume":"29","author":"WY Zhu","year":"2012","unstructured":"Zhu WY, Liu TG, Zhu H. Long-term recurrence-free survival in a patient with pancreatic carcinosarcoma: a case report with a literature review. Med Oncol. 2012;29:140\u20133.","journal-title":"Med Oncol"},{"key":"1879_CR27","first-page":"212","volume":"14","author":"E Oymaci","year":"2013","unstructured":"Oymaci E, Argon A, Co\u015fkun A, U\u00e7ar AD, Carti E, Erkan N, Yildirim M. Pancreatic carcinosarcoma: case report of a rare type of pancreatic neoplasia. JOP. 2013;14:212\u20135.","journal-title":"JOP."},{"key":"1879_CR28","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1111\/his.12975","volume":"69","author":"Q Bai","year":"2016","unstructured":"Bai Q, Zhang X, Zhu X, Wan L, Huang D, Cai X, Zhou X, Wang J, Sheng W. Pancreatic carcinosarcoma with the same KRAS gene mutation in both carcinomatous and sarcomatous components: molecular evidence for monoclonal origin of the tumour. Histopathology. 2016;69:393\u2013405.","journal-title":"Histopathology."},{"key":"1879_CR29","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1097\/MPA.0000000000000904","volume":"46","author":"DA Russ","year":"2017","unstructured":"Russ DA, Kayser C, Neubauer J, Fichtner-Feigle S, Hopt UT, Wittel UA. Carcinosarcoma of the pancreas: case report with comprehensive literature review. Pancreas. 2017;46:1225\u201333.","journal-title":"Pancreas."},{"key":"1879_CR30","doi-asserted-by":"publisher","first-page":"e5966","DOI":"10.1097\/MD.0000000000005966","volume":"96","author":"Z Jia","year":"2017","unstructured":"Jia Z, Zhang K, Huang R, Zhou X, Jiang L. Pancreatic carcinosarcoma with rare long-term survival: case report and review of the literature. Medicine (Baltimore). 2017;96:e5966.","journal-title":"Medicine (Baltimore)"},{"key":"1879_CR31","doi-asserted-by":"publisher","first-page":"e6961","DOI":"10.1097\/MD.0000000000006961","volume":"96","author":"BQ Li","year":"2017","unstructured":"Li BQ, Liu QF, Chang XY, Hu Y, Chen J, Guo JC. Pancreatic carcinosarcoma mimics malignant intraductal papillary mucinous neoplasm: a rare case report and literature review. Medicine (Baltimore). 2017;96:e6961.","journal-title":"Medicine (Baltimore)"},{"key":"1879_CR32","first-page":"1","volume":"5","author":"CJ Salibay","year":"2017","unstructured":"Salibay CJ, Rewerska J, Gupta S, Ree N. Primary carcinosarcoma of the pancreas with CD10-positive sarcoma component. J Investig Med High Impact Case Rep. 2017;5:1\u20134.","journal-title":"J Investig Med High Impact Case Rep"},{"key":"1879_CR33","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1097\/PAS.0000000000000689","volume":"40","author":"T Muraki","year":"2016","unstructured":"Muraki T, Reid MD, Basturk O, Jang KT, Bedolla G, Bagci P, Mittal P, Memis B, Katabi N, Bandyopadhyay S, Sarmiento JM, Krasinskas A, Klimstra DS, Adsay V. Undifferentiated carcinoma with osteoclastic giant cells of the pancreas: clinicopathologic analysis of 38 cases highlights a more protracted clinical course than currently appreciated. Am J Surg Pathol. 2016;40:1203\u201316.","journal-title":"Am J Surg Pathol"},{"key":"1879_CR34","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.humpath.2018.07.006","volume":"81","author":"C Luchini","year":"2018","unstructured":"Luchini C, Cros J, Pea A, Pilati C, Veronese N, Rusev B, Capelli P, Mafficini A, Nottegar A, Brosens LAA, No\u00eb M, Offerhaus GJA, Chianchiano P, Riva G, Piccoli P, Parolini C, Malleo G, Lawlor RT, Corbo V, Sperandio N, Barbareschi M, Fassan M, Cheng L, Wood LD, Scarpa A. PD-1, PD-L1, and CD163 in pancreatic undifferentiated carcinoma with osteoclast-like giant cells: expression patterns and clinical implications. Hum Pathol. 2018;81:157\u201365.","journal-title":"Hum Pathol"},{"key":"1879_CR35","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1093\/ajcp\/aqx092","volume":"148","author":"HD Lehrke","year":"2017","unstructured":"Lehrke HD, Graham RP, McWilliams RR, Lam-Himlin DM, Smyrk TC, Jenkins S, Dong H, Zhang L. Undifferentiated pancreatic carcinomas display enrichment for frequency and extent of PD-L1 expression by tumor cells. Am J Clin Pathol. 2017;148:441\u20139.","journal-title":"Am J Clin Pathol"}],"container-title":["World Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-020-01879-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12957-020-01879-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-020-01879-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T23:09:07Z","timestamp":1621897747000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjso.biomedcentral.com\/articles\/10.1186\/s12957-020-01879-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,25]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1879"],"URL":"https:\/\/doi.org\/10.1186\/s12957-020-01879-8","relation":{},"ISSN":["1477-7819"],"issn-type":[{"type":"electronic","value":"1477-7819"}],"subject":[],"published":{"date-parts":[[2020,5,25]]},"assertion":[{"value":"9 March 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 May 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All procedures in this study were approved by the Ethical Committee of the National Hospital Organization.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for the publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"105"}}