Pancreatic sarcoma

　　Firstly, etiology

　　Currently, there is no relevant information available.

　　Secondly, pathogenesis

　　The main components of pancreatic sarcoma mostly originate from the connective tissue, blood vessels, and nerve tissues of the pancreas. There is no consensus on whether lymphosarcoma originates from the pancreas and whether it truly belongs to pancreatic sarcoma. According to general pathological classification, there are fibrosarcoma, leiomyosarcoma, neurofibrosarcoma, lymphosarcoma, liposarcoma, malignant neurilemmoma, reticulosarcoma, angiosarcoma, extramedullary plasmacytoma, and rhabdomyosarcoma, among which fibrosarcoma is the most common. Sarcomas can occur in any part of the pancreas, and their malignancy is lower than that of pancreatic cancer.

　　When the tumor of the pancreatic head compresses the common bile duct, obstructive jaundice may occur; if the tumor invades the duodenum, it can cause duodenal obstruction; and if the tumor grows too large, it may appear central necrosis, hemorrhage, and cystic change.

　　Obstructive jaundice is caused by the blockage of extrahepatic bile ducts or intrahepatic bile ducts, which is called extrahepatic obstructive jaundice in the former; and intrahepatic obstructive jaundice in the latter.

　　Pancreatic sarcoma can occur in any part of the pancreas, and the clinical symptoms are related to the size and location of the tumor. In the early stage, when the tumor is small, there may be no symptoms, and it may be found incidentally during B-ultrasound or CT examination. Most pancreatic sarcomas are found when the tumor is already quite large.

　　This disease often occurs in adolescents, even infants and young children. During the growth process of the tumor, patients may experience dull pain and discomfort in the upper abdomen, and if the abdominal cavity nerves are compressed or invaded, it may cause lumbar and back pain. Half of the patients may feel a hard mass in the upper abdomen when they visit the doctor, with poor mobility. The tumor compressing or stimulating the gastrointestinal tract may cause nausea and vomiting. In the late stage of the disease, patients may have low fever and a decrease in body weight due to consumption.

　　1, Develop good living habits, quit smoking and limit alcohol consumption. Smoking, according to the World Health Organization's prediction, if people stop smoking, the world's cancer rate will decrease by 1/3 after 5 years; secondly, do not overindulge in alcohol. Both smoke and alcohol are highly acidic substances, and those who smoke and drink for a long time are prone to develop an acidic体质.

　　2, Do not eat too much salty and spicy food, do not eat overheated, cold, expired, or deteriorated food; for the elderly, weak, or those with certain genetic diseases, eat some cancer-preventive foods and alkaline foods with high alkalinity in moderation to maintain a good mental state.

　　Imaging examinations are very important for the diagnosis of pancreatic sarcoma. Ultrasound can detect large, homogeneous, and clearly defined solid masses in the pancreatic region. Barium meal examination of the gastrointestinal tract can detect phenomena of compression or displacement of the stomach and duodenum. CT and MRI can detect space-occupying lesions or local enlargement in the pancreatic region, with increased, homogeneous, and clearly defined mass density. At the same time, the relationship between the mass, large blood vessels, and surrounding organs can also be reflected. ERCP examination can detect phenomena such as compression, sudden interruption, and distension of the distal pancreatic duct. Angiography examination can detect a reduction in blood vessels in the tumor area, which is similar to the manifestations of pancreatic cysts, cystadenomas, and cystadenocarcinomas. Fine needle aspiration biopsy of the pancreas under the guidance of ultrasound or CT is a good pathological diagnostic method that can make an accurate diagnosis, but it has certain risks, including the possibility of misinjection into surrounding large blood vessels and organs, and requires the operator to have rich experience. It is not widely used at present.

　　Dietary taboos are crucial for the recovery of this disease. As an important principle, in clinical practice, patients with pancreatic cancer during treatment should eat easily digestible and light foods in moderation, and should not overeat or overfill. Especially for high-fat and high-protein foods such as turtle, crab, shrimp, and others, they are absolutely禁忌. For high-calorie foods rich in animal fat such as beef and mutton, caution should also be exercised. Spicy and刺激性 foods should be avoided to prevent the recurrence of the disease.

　　1. Treatment

　　Surgical treatment is the preferred method, striving for complete resection of the tumor. Pancreaticoduodenectomy is performed for pancreatic head tumors, pancreatectomy and splenectomy for pancreatic body and tail tumors, and partial resection of the stomach and colon can be combined when surrounding organs such as the stomach and colon are involved. Pancreatic sarcoma rarely has distant metastasis or lymph node metastasis, and resection should not be abandoned as long as there is no invasion of large blood vessels or liver metastasis.

　　2. Prognosis

　　There are few reports on the prognosis of pancreatic sarcoma, and there are reports in literature of long-term survival after complete resection of the tumor. If liver metastasis or other findings are discovered before or during surgery, the prognosis is usually poor.