case_images: PMC11100631_01
case_images: Axial contrast enhanced computed tomography image showing a well-defined heterogeneously enhancing lesion (arrow) in the body of the pancreas (P), suspicious for either a primary pancreatic neoplasm or metastasis
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case_images: Computed tomography scan of the abdomen showed a relatively well-defined heterogeneously enhancing lesion measuring about 4.6 cm x 3.3 cm x 3.2 cm involving the body of the pancreas and abutting the stomach [Figure 1].
case_images: Resected specimen showing a tumor within the pancreas
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case_images: Grossly, a primary tumor of 5 cm x 5 cm was identified in the body of the pancreas infiltrating the posterior wall of the stomach [Figure 2].
case_images: (a) Tumor surrounded by adjacent benign pancreatic tissue (H and E, x100), (b) High grade papillary tumor (H and E, x400)
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case_images: It showed features of high-grade serous papillary adenocarcinoma which were morphological identical to the previous surgical resected specimen of the ovarian mass which she had in the year November 2010 [Figure 3].
case_images: Photomicrographs showing immunohistochemical profile of the tumor cells. (a) Nuclear positivity for paired-box gene 8 (immunohistochemistry [IHC]; x200), (b) Positive membranous expression of CK7 (IHC, x100), (c) Focal and distinct nuclear staining for Wilms' tumor protein (IHC, x400), (d) Diffuse strong nuclear positivity of p53 mutated protein (IHC, x100)
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case_images: IHC studies further showed the tumor to be positive for WT-1, PAX8, CK7, ER, and p53 while being negative for CK20, CDX2, TTF-1, PR, carcinoembryonic antigen, carbohydrate antigen 19-9, and calretinin indicating ovarian tumor as its origin [Figure 4].