PMC7551979_01
Contrast enhanced CT scan showed the tumor in the head of the pancreas.
gr1.jpg
PMC7551979_01_gr1.jpg
fig0005
A 21,7 ng/mL (RR: <102) and NSE 10,9 ug/L (RR: 0-16,3). A contrast enhanced CT-scan (Fig. 1) revealed a 7 cm mass within the head of the pancreas with no apparent vascular or surrounding organ invasion.
Biopsy specimen showing pancreatic tissue with a solid, vessel-rich pattern and high grade mesenchimatous neoplastic cells (HE x50 and HE x400).
gr2.jpg
PMC7551979_01_gr2.jpg
fig0010
The histological examination of the pancreatic biopsy (Fig. 2) showed a solid pattern neoplasm consisting of spindle and epithelioid cells, richly vascularized with moderate to intense nuclear pleomorphism and the presence of atypical endothelial cells.
Immunohistochemical staining, with positivity for CD34 (A), Fli-1 (B), CD31 (C) and Factor VIII (D).
gr3.jpg
PMC7551979_01_gr3.jpg
fig0015
Immunohistochemical studies (Fig. 3) demonstrated positive staining for vimentin and endothelial markers CD34, CD31, factor VIII and Fli-1, but negativity for AE1/AE3, SMA, desmin, DOG-1, CD117 and pS100, thus establishing the diagnosis of pancreatic angiosarcoma.