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Retroperitoneal liposarcoma with pancreatic metastasis and gastric cancer: a case report

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Abstract

On computed tomography scanning, a 63-year-old man with vomiting and anorexia was discovered to have a mass in the pancreatic body and a retroperitoneal mass extending to the right lobe of the liver. An esophagogastroduodenoscopy revealed an advanced gastric carcinoma in the middle gastric body, and a biopsy specimen revealed a poorly differentiated adenocarcinoma. The pancreatic and retroperitoneal masses were considered metastatic lesions of gastric cancer, and a biopsy was taken from the pancreatic lesion using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The histology of the EUS-FNA pancreatic specimen revealed atypical spindle-shaped cells and increased stromal collagen fibrosis, and liposarcoma was considered. Conversely, a percutaneous ultrasound-guided biopsy was taken for the retroperitoneal lesion, and the histology revealed that it was a dedifferentiated liposarcoma. On the basis of histopathological and imaging findings, the retroperitoneal liposarcoma was identified as the primary lesion, the pancreatic lesion as a metastasis of the primary liposarcoma, and the gastric carcinoma as an independent tumor. As far as we know, there have only been three reports of metastatic pancreatic liposarcoma diagnosed via EUS-FNA. In this case, the patient also had gastric cancer, and EUS-FNA was helpful in differentiating metastatic pancreatic tumors from gastric cancer.

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Acknowledgements

We would like to express our gratitude to the entire endoscopy medical staff for their assistance with the endoscopic procedures. Additionally, we are deeply grateful to Dr. Yasuko Murakawa of the Department of Cancer Chemotherapy, Miyagi Cancer Center, who was in charge of the patient’s chemotherapy and provided endoscopic images after chemotherapy.

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Authors and Affiliations

  1. Department of Gastroenterology, Soma General Hospital, Soma, Japan

    Naoto Abe, Yuichi Waragai, Yuta Takahashi, Ryoichiro Kobashi, Takumi Yanagita & Hiromi Kumakawa

  2. Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan

    Naoto Abe, Yuichi Waragai, Ryoichiro Kobashi, Takumi Yanagita & Hiromasa Ohira

  3. Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Takuto Hikichi, Yuichi Waragai, Ryoichiro Kobashi & Masao Kobayakawa

  4. Fukushima Pathological Research Center, Fukushima, Japan

    Kazuo Watanabe

  5. Medical Research Center, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan

    Masao Kobayakawa

Authors
  1. Naoto Abe
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  2. Takuto Hikichi
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  3. Yuichi Waragai
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  4. Yuta Takahashi
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  6. Takumi Yanagita
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  7. Hiromi Kumakawa
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  8. Kazuo Watanabe
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  9. Masao Kobayakawa
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  10. Hiromasa Ohira
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Contributions

NA, TH, and YW conceived and designed this case report. NA, YW, YT, RK, TY, and HK performed the endoscopic procedures and patient management. Kazuo Watanabe conducted the pathological evaluation. NA, TH, and YW wrote the first draft of the manuscript. MK and HO commented on the previous version of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Takuto Hikichi.

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Conflict of interest

Naoto Abe, Takuto Hikichi, Yuichi Waragai, Yuta Takahashi, Ryoichiro Kobashi, Takumi Yanagita, Hiromi Kumakawa, Kazuo Watanabe, Masao Kobayakawa, and Hiromasa Ohira declare no conflicts of interest for this article.

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Abe, N., Hikichi, T., Waragai, Y. et al. Retroperitoneal liposarcoma with pancreatic metastasis and gastric cancer: a case report. Clin J Gastroenterol 16, 164–170 (2023). https://doi.org/10.1007/s12328-022-01742-1

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  • DOI: https://doi.org/10.1007/s12328-022-01742-1

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