Solitary Pancreatic Metastasis From Dermatofibrosarcoma Protuberans: A Diagnostic Challenge Mimicking Primary Pancreatic Carcinoma.

Zhang, Zeyu; Zuo, Changjing; Zhou, Xia; Yang, Yelin; Cheng, Chao · Clin Nucl Med · 2026

case_report · Level V

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Abstract

A 56-year-old man presented with hyperglycemia and weight loss. Imaging revealed a pancreatic head mass with features suggestive of primary pancreatic carcinoma. 18 F-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.

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