A 56-year-old man presented with hyperglycemia and weight loss. Imaging revealed a pancreatic head mass with features suggestive of primary pancreatic carcinoma. 18F-FDG PET/CT confirmed a hypermetabolic lesion without evidence of distant metastasis. Following the Whipple procedure, histopathology and immunohistochemistry (CD34+, Vimentin+), together with a history of resected ankle sarcoma, established the diagnosis of a solitary pancreatic metastasis from dermatofibrosarcoma protuberans (DFSP). This case highlights the diagnostic difficulty posed by solitary pancreatic metastases, which can closely mimic primary pancreatic cancer. A comprehensive approach integrating clinical history, tumor markers, and multimodality imaging is essential for accurate differentiation.
Zhang et al. (Thu,) studied this question.