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BACKGROUND Sarcomatoid carcinoma of the pancreas is extremely rare and has an extremely poor prognosis.Although a few cases of sarcomatoid carcinoma of pancreas have been reported,most are focused on a histopathological review.To the best of our knowledge,there are no reports documenting multimodality imaging characteristics and chronological changes with emphasis on radiologic features.CASE SUMMARY A 64-year-old woman was admitted to Chungnam National University Hospital with acute appendicitis.Contrast-enhanced computed tomography of the abdomen revealed a 2.6 cm×2.8 cm multilobular cystic mass in the pancreatic tail.The pancreatic lesion showed suspected mural nodules and thin septa.Hence,mucinous cystic neoplasm of pancreas was considered.After 7 mo,the patient was readmitted for repeated epigastric abdominal pain and nausea.Follow-up contrast-enhanced computed tomography of the abdomen and magnetic resonance imaging revealed a marked enlargement(5.4 cm×4 cm),with a predominant internal solid component.The mass showed low signal intensity on a T1-weighted image and heterogeneously intermediate high signal intensity on a T2-weighted image. It showed diffusion restriction and peripheral rimenhancement on an arterial phase image, and progressive enhancement on portalvenous and delayed phase images. Distal pancreatectomy was performed. Basedon the morphology and immunohistochemical staining of the specimen,pancreatic sarcomatoid carcinoma was diagnosed.CONCLUSIONWe present the computed tomography, magnetic resonance imaging, and positronemission tomography computed tomography findings, pathologic features, andchronological changes for preoperative diagnosis.
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