Multi slice computed tomography for the diagnosis of pancreatic sarcomatoid carcinoma

Pancreatic sarcomatoid carcinoma is an extremely rare malignant tumor. The clinical data and computed tomography images of 8 patients with pancreatic sarcomatoid carcinoma who were admitted to the Subei People′s Hospital from March 2001 to January 2013 were retrospectively analyzed. The results of computed tomography showed that 8 tumors were cystic and solid, showing exophytic growth. Two tumors were located in the pancreatic head, 1 in the pancratic neck, 3 in the body of pancreas, and 2 in the tail of the pancreas. The shape of the tumors were round or ellipse, and the mean tumor diameter was (7.2±1.8)cm (range, 6.39.6 cm). The plain scan of computed tomography showed that the attenuation of the tumors was mild hyperdense (7 cases) or equal to pancreatic tissue (1 case). Tumors were solid with cystic components, and no hemorrhage within the tumor was detected. Small calcification nodule was detected in 1 case. The enhanced scan of computed tomography showed that the enhancement of the tumor was moderate; the enhancement of the tumor was higher than that of normal pancreatic parenchyma during venous phase and delayed phase, while lower than that of normal pancreatic parenchyma on arterial phase; the enhancement of tumors was significantly lower than that of aorta during all the enhanced phases. All the tumors had complete capsule, and abnormal enhancement of the capsule was not detected. Three tumors had peripancreatic lymphadenectasis, 2 had infiltration of splenic artery, 2 had infiltration of splenic flexure of colon and 1 had infiltration of duodenal serosa or muscle. Familiarity with the imaging features of the pancreatic sarcomatoid carcinoma can help surgeons to make a suggestive diagnosis.