case_images: PMC10184239_01
case_images: Chest x-ray (A) and computed tomography scans (B, C, and D) revealed an eggshell cystic lesion in the pancreas tail (yellow arrow) and a heterogeneous mass in the spleen (red arrow).
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case_images: The chest plain film showed a calcified-rim mass in the left upper abdomen (Figure 1A). The contrast-enhanced abdominal computed tomography (CT) revealed a heterogeneously enhanced hypodense lesion measuring 9.5 cm x 8.1 cm x 5.9 cm at the spleen and a large cyst with eggshell calcification measuring 6.4 cm x 6.2 cm x 6.2 cm at pancreas tail, without metastatic lesion (Figure 1B).
case_images: Laparoscopic removal of a pancreas tail tumor invading the spleen.
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case_images: Laparoscopic removal of a pancreas tail tumor invading the spleen, as shown in Figure 2, was performed without any difficulty.
case_images: Pathological findings of the tumor. (A) Squamous cell carcinoma in the wall of the cystic lesion in the pancreas tail (hematoxylin and eosin, x 200); (B) Spleen invaded by the tumor (hematoxylin and eosin, x 200); (C) Squamous cell carcinoma with keratinization (black arrow) (hematoxylin and eosin, x 200); (D) Tumor cells are P40 positive (p40 immunohistochemistry, x 200).
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case_images: The pathological report disclosed that the tumor originated from the cystic wall and invaded peripancreatic soft tissues and the spleen. (Figure 3A and B) The tumor was composed of squamous cell carcinoma with keratinization. (Figure 3C) Moreover, the tumor's morphological appearances were considered moderately differentiated squamous cell carcinoma, confirmed with strong diffuse immunostaining with P40 and patchy positive of P16. (Figure 3D) The tumor had lymphovascular invasion and perineural invasion.