73 years old male withouth comorbidities presents a pyloric syndrome and he is anycteric during image evaluation we observed a 68 mm heterogeneus mass in head of the pancreas at abdomen ct. He underwent an echoendoscpy that revealed heterogeneous mass in head of the pancreas without vascular invasion, the biopsy revealled a low grade leyomiosarcoma ( ki67 5 %) see imunohistochemical panel. Pet ct showed no distance dissemination. The question is resection or no? If an intraoperative evaluation, a vascular invasion either superior mesenteric vein or artery is found, should we resect it's or no?
EUS is a very sensitive tool for vascular invasion either superior mesenteric vein or artery , how about is it?If there is no invasion, you should resect
At ct evaluation the radiologist suggested an invasion of the both superior mesenteric vein and artery. But i agree with you, we should try to resect the lesion.
To make the local resection and reconstruction of the vascular affectation
Liemyosacroma of the pancrease extremely rare and highly locally aggressive tumor . The involvement of SMV And portal vein not longer consider containdicaion of surgical resection provide the narrowing consider is less than 50%.however the SMA involvement still consider absolute contraindications for curative resection
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