case_images: PMC9514425_01
case_images: Timeline of treatment and disease characteristics. ChT, chemotherapy; CT, computed tomography; GemOx, gemcitabine oxaliplatin; ER, estrogen receptor; PR, progesterone receptor.
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case_images: Three years later, she developed enlarged lymph nodes in the mesentery and was treated with 6 cycles of cisplatin plus etoposide with combination of interferon and octreotide ( Figure 1 ).
case_images: Contrast-enhanced CT scan image (Axial image). (A) Liver metastases from SPN of the pancreas in right lobe of liver at baseline examination. CT scan shows hematogenous dissemination of malignant nodules in the peritoneal space, retroperitoneal spaces at baseline examination. (B) Liver metastases from SPN of the pancreas in right lobe of liver after treatment. CT scan shows hematogenous dissemination of malignant nodules in the peritoneal space, retroperitoneal spaces after treatment. Picture 1 (A, B). SPN of the Pancreas: The tumor is represented by monomorphic polygonal and rounded cells with the formation of capillary-like (pseudopapillary) structures formed as a result of violation of intercellular contacts. Tumor cells surround blood capillaries in the form of rosettes. (H&E, kh20). (C). SPN of the Pancreas: The tumor grows into the wall of the small intestine. (H&E, kh20) (D). SPN of the Pancreas: Tumor metastasis to liver tissue (H&E, kh20).
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case_images: In May 2021, the progression became unresectable because of the occurrence of carcinomatosis in the abdominal cavity, pelvis, along the diaphragm and metastatic foci in the liver ( Figure 2A ). Since then CT scan from May 2022 showed durable stable effect ( Figure 2B ).
case_images: Immunoprofile of SPN: nuclear and cytoplasmic reaction with antibodies to beta-catenin, cytoplasmic reaction with Synaptophysin, CD10, nuclear expression of ER and PR in 90% of tumor cells.
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case_images: The IHC staining was performed which revealed positivity for CD10, beta-catenin, Synaptophysin ( Figure 3 ). However, IHC analysis showed 7 by Allred score of estrogen receptors (ER) and progesterone receptors (PR) ( Figure 3 ) in the tumor tissue, respectively.