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Rare hypervascular pancreatic tumors diagnosed as asynchronous metastases of central nervous system solitary fibrous tumor/hemangiopericytoma

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Abstract

A 70-year-old woman was referred to our hospital for asymptomatic pancreatic tumors. She had a history of hemagiopericytoma (HPC) about 20 years ago, and no apparent recurrence has been observed. Contrast-enhanced computed tomography revealed two hypervascular tumors in the head and uncinate process of the pancreas, and no obvious neoplastic lesions were found in other organs. Endoscopic ultrasound guided fine-needle aspiration cytology was performed and histopathology showed that spindle-shaped tumor cells were arranged in a hemangiopericytoma-like pattern and positive for STAT6, which was a characteristic feature of solitary fibrous tumors (SFTs). Immunohistochemical staining for surgical pathology specimens from past HPC showed positive expression of STAT6, which was Grade 2 central nervous system solitary fibrous tumor/hemagiopericytoma (CNS SFT/HPC) according to the current WHO classification. From these findings, the pancreatic tumors were preoperatively diagnosed as pancreatic metastases of CNS SFT/HPC. She underwent pancreaticoduodenectomy. Histopathological examination of the surgically resected specimen proved that the both pancreatic tumors were SFT/HPC. Thus, pancreatic tumors were finally diagnosed as asynchronous pancreatic metastases from CNS SFT/HPC. Although extremely rare, metastatic pancreatic tumors derived from SFT/HPC should be considered as a differential diagnosis for hypervascular pancreatic tumors, especially when having a past history of brain tumors.

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Abbreviations

HPC:

Hemagiopericytoma

CT:

Computed tomography

EUS-FNA:

Endoscopic ultrasound guided fine-needle aspiration

SFT:

Solitary fibrous tumor

CNS SFT/HPC:

Central nervous system solitary fibrous tumor/hemangiopericytoma

MRI:

Magnetic resonance imaging

MEN-1:

Multiple Endocrine Neoplasia 1

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Kenta Mizukoshi, Akihisa Fukuda & Hiroshi Seno

  2. Department of Gastroenterology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinamba-cho, Amagasaki, Hyogo, 660-8550, Japan

    Yuki Yamauchi & Mami Kitaura

Authors
  1. Kenta Mizukoshi
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  2. Yuki Yamauchi
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  3. Mami Kitaura
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  4. Akihisa Fukuda
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  5. Hiroshi Seno
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Contributions

KM YY, and MK participated in diagnosis and drafted this manuscript. AF and HS supervised this manuscript. All authors read and approved the final manuscript.

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Correspondence to Kenta Mizukoshi.

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Mizukoshi, K., Yamauchi, Y., Kitaura, M. et al. Rare hypervascular pancreatic tumors diagnosed as asynchronous metastases of central nervous system solitary fibrous tumor/hemangiopericytoma. Clin J Gastroenterol 15, 221–227 (2022). https://doi.org/10.1007/s12328-021-01533-0

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  • DOI: https://doi.org/10.1007/s12328-021-01533-0

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