An Emergent Case of Pancreatic Cancer; Adenosquamous Carcinoma with Sarcomatoid Change

The case describes a 39 year old male that presented with epigastric pain, nausea and constipation. A computed tomography revealed a 2x3 cm lesion in the head of the pancreas. The patient was referred to our institution and a high contrast computed tomography showed the lesion to have grown to 5x5 cm within a period of 15 days. Biopsies were obtained from the pancreatic mass. However, a few days later the patient went into circulatory shock and was transported to the intensive care unit where he was treated for acute onset liver and kidney failure. The patient's condition progressively worsened and despite all efforts of resuscitation, he passed away. Final immunohistochemical analysis revealed a poorly differentiated pancreatic adenosquamous carcinoma with sarcomatoid characteristics. pancreatic adenosquamous carcinoma is a rare exocrine pancreatic tumor demonstrated to have a more aggressive disease course than ductal adenocarcinoma. The additional sarcomatoid component in the tumor may have further promoted cancer cell proliferation and metastatic dissemination. The present case highlights the complex dynamism of pancreatic cancer and that a rapid growth rate of a pancreatic mass should not preclude the suspicion of malignancy.