Perivascular epithelioid cell tumor: the first malignant case report in the pancreas

Appl Immunohistochem Mol Morphol. 2013 May;21(3):e1-4. doi: 10.1097/PAI.0b013e3182392bb6.

Abstract

Pancreatic perivascular epithelioid cell tumors (PEComas) are exceedingly rare neoplasms, <10 cases have been described; all were benign and occurring mostly in women. We report the first malignant pancreatic PEComa in a patient with BRCA2 mutation. A 51-year-old woman with a medical and familial history of breast adenocarcinoma, who was tested positive for BRCA2 mutation, presented with a recent history of jaundice. Imaging studies were consistent with endocrine or secondary tumor. Pathologic examination of fine needle aspiration biopsy and Whipple procedure revealed a 6-cm intrapancreatic PEComa, invading the duodenal wall with extensive necrosis and vascular invasion, leading to classify this PEComa into "malignant" category. The patient developed liver metastases 6 months after surgery. Although mostly benign, thorough sampling of the PEComa is mandatory, to rule out malignant behavior whatever the location of the tumor is.

Publication types

  • Case Reports

MeSH terms

  • BRCA2 Protein / genetics
  • Biopsy, Fine-Needle
  • Duodenal Neoplasms / genetics
  • Duodenal Neoplasms / secondary*
  • Female
  • Humans
  • Liver Neoplasms / genetics
  • Liver Neoplasms / secondary*
  • Middle Aged
  • Mutation
  • Pancreatic Neoplasms / genetics
  • Pancreatic Neoplasms / pathology*
  • Perivascular Epithelioid Cell Neoplasms / genetics
  • Perivascular Epithelioid Cell Neoplasms / pathology*

Substances

  • BRCA2 Protein
  • BRCA2 protein, human