This patient's history and presentation are rather typical for a sarcoma or metastatic carcinoma but not so much for a lymphoma.
Composite malignant tumors containing both carcinomatous and sarcomatous components are known as carcinosarcomas.
A phase-II study for abdominal sarcomatosis in 11 patients achieved a response in 45%, albeit the follow up was relatively short.
When one encounters a patient with hydrocephalus with or without diffuse meningeal enhancement on radiologic studies, meningeal sarcomatosis should be considered in the differential diagnosis.
To our knowledge, this carcinosarcoma is the seventh reported case of a primary pancreatic neoplasm with mixed carcinomatous and sarcomatous elements.
Sebaceous cysts, fibromas, papillomas, adenomas, sarcomas , carcinomas, and melanomas also have been reported.
Dacarbazine is a chemotherapeutic agent that has been successfully applied to treat various types of cancer such as Hodgkin's disease, malignant melanomas, soft tissue sarcomas and advanced neuroblastomas.
Unlike carcinomas, metastatic sarcomas generally occur deeper and may not ulcerate the mucosa.
Histologically, the tumor was composed of both carcinomatous and sarcomatous elements.
The carcinomatous component is almost always squamous cell carcinoma, and the sarcomatous component usually contains a pleomorphic spindle cell proliferation.