Analysis of the hypovirulent Klebsiella pneumoniae with the NDM-5 gene on IncN plasmids.

IMPORTANCE: It is crucial to strengthen the ongoing clinical surveillance of non-highly virulent, multi-resistant Klebsiella pneumoniae.

Comparative diagnostic accuracy of multiparametric magnetic resonance imaging-ultrasound fusion-guided biopsy versus systematic biopsy for clinically significant prostate cancer.

Purpose: To examine the accuracy of transperineal magnetic resonance imaging (MRI)-ultrasound (US) fusion biopsy (FB) in identifying men with prostate cancer (PCa) that has reached a clinically relevant stage. Methods: This investigation enrolled 459 males. In 210 of these patients (FB group), transperineal MRI/US fusion-guided biopsies were performed on the suspicious region, and in 249 others, a systematic biopsy (SB) was performed (SB group). We compared these groups using Gleason scores and rates of cancer detection. Results: PCa cases counted 198/459 (43.1%), including 94/249 (37.8%) in the SB group and 104/210 (49.5%) in the FB group. FB was associated with higher overall diagnostic accuracy relative to SB (88.5% and 72.3%, P = 0.024). FB exhibited greater sensitivity than SB (88.9% and 71.2%, P = 0.025). The area under the curve for FB and SB approaches was 0.837 and 0.737, respectively, such that FB was associated with an 11.9% increase in accuracy as determined based upon these AUC values. Relative to SB, FB was better able to detect high-grade tumors (GS ≥ 7) (78.85% vs. 60.64%, P = 0.025). Conclusion: Transperineal MRI-US fusion targeted biopsy is superior to the systematic one as an approach to diagnosing clinically significant PCa, as it is a viable technical approach to prostate biopsy.

Functional Portrait and Genomic Feature of Carbapenem-Resistant Pseudomonas mendocina Harboring blaNDM-1 and blaIMP-1 in China.

The purpose of this research was to analyze the functional portraits and genomic features of carbapenem-resistant Pseudomonas mendocina carrying NDM-1 and IMP-1. The resistance mechanism of the strain was verified by in vivo experiments. Genomic data were aligned and analyzed in the NCBI database. Growth curve measurements were used to describe the growth characteristics of the bacteria. The virulence of P. mendocina strain was analyzed by serum killing assay and biofilm formation assay. Plasmid conjugation experiments were performed to verify the transferability of plasmids carrying drug-resistance genes. The P. mendocina strain was highly resistant to carbapenems. In addition, ST typing is unknown and has been submitted to Genebank. The strain carried two carbapenemase genes, including NDM-1 and IMP-1. Among them, blaNDM-1 was located on a 5.62832 Mb chromosome, and blaIMP-1 was located on a 172.851 Kb transferable plasmid, which was a very close relative of pIMP-NY7610 in China. The strain also had a variety of virulence genes, which were expressed in the siderophore, capsule, pilus, alginate, flagella, etc. The study suggests that the functional portrait and genomic features of carbapenem-resistant P. mendocina harboring blaNDM-1 and blaIMP-1 are unique to China. This outcome represents antibiotic resistance exhibited in the genus Pseudomonas by acquiring chromosomes and plasmid genes. The monitoring and supervision of antimicrobial usage must be strengthened since the multi-drug-resistant and moderately virulent P. mendocina will attract much attention in the near future.

Four thermostatic steps: A novel CRISPR-Cas12-based system for the rapid at-home detection of respiratory pathogens.

The outbreak of coronavirus disease 2019 (COVID-19) in 2019 has severely damaged the world's economy and public health and made people pay more attention to respiratory infectious diseases. However, traditional quantitative real-time polymerase chain reaction (qRT-PCR) nucleic acid detection kits require RNA extraction, reverse transcription, and amplification, as well as the support of large-scale equipment to enrich and purify nucleic acids and precise temperature control. Therefore, novel, fast, convenient, sensitive and specific detection methods are urgently being developed and moving to proof of concept test. In this study, we developed a new nucleic acid detection system, referred to as 4 Thermostatic steps (4TS), which innovatively allows all the detection processes to be completed in a constant temperature device, which performs extraction, amplification, cutting of targets, and detection within 40 min. The assay can specifically and sensitively detect five respiratory pathogens, namely SARS-CoV-2, Mycoplasma felis (MF), Chlamydia felis (CF), Feline calicivirus (FCV), and Feline herpes virus (FHV). In addition, a cost-effective and practical small-scale reaction device was designed and developed to maintain stable reaction conditions. The results of the detection of the five viruses show that the sensitivity of the system is greater than 94%, and specificity is 100%. The 4TS system does not require complex equipment, which makes it convenient and fast to operate, and allows immediate testing for suspected infectious agents at home or in small clinics. Therefore, the assay system has diagnostic value and significant potential for further reducing the cost of early screening of infectious diseases and expanding its application. KEY POINTS: • The 4TS system enables the accurate and specific detection of nucleic acid of pathogens at 37 °C in four simple steps, and the whole process only takes 40 min. •A simple alkali solution can be used to extract nucleic acid. • A small portable device simple to operate is developed for home diagnosis and detection of respiratory pathogens.

Case report: Severe pneumonia and pneumomediastinum in a previously robust adolescent caused by Omicron BA.5.2.

The manifestation of severe pneumonia is only occasional, and pneumomediastinum is a condition that occurs rarely in Coronavirus disease 2019 (COVID-19) patients, especially in those patients who are infected with the Omicron variant. In addition, whether severe pneumonia or pneumomediastinum often occurs in patients in older age, in poor physical condition, or with underlying diseases remains to be ascertained. To date, severe pneumonia and pneumomediastinum due to Omicron infection had not been reported in a young patient with an excellent physical condition. In this study, we report such a case with the aforementioned manifestations in a robust adolescent infected with Omicron BA.5.2.

Ultrasound-guided perineal laser ablation versus prostatic arterial embolization for benign prostatic hyperplasia: two similar short-term efficacies.

BACKGROUND: There are many ways to treat prostatic hyperplasia; these are currently more inclined to minimally invasive treatment. We mainly compared the differences between two treatment methods， ultrasound-guided transperineal laser ablation (US-TPLA) and prostatic artery embolization (PAE). PURPOSE: To evaluate the efficacy and safety of US-TPLA and PAE in the treatment of benign prostatic hyperplasia (BPH). MATERIAL AND METHODS: The clinical information for 40 patients with BPH admitted to our hospital between June 2018 and January 2021 were retrospectively analyzed. The changes in International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume (PV), and the incidence of complications were compared between groups. RESULTS: The IPSS (P < 0.001; P < 0.001), QoL (P < 0.001; P < 0.001), Qmax (P < 0.001; P < 0.001), PVR (P < 0.001; P < 0.001), and PV (P < 0.001; P < 0.001) at three and six months after US-TPLA and PAE improved with respect to those before surgery. There was no significant difference in IPSS (P = 0.235; P = 0.151), QoL (P = 0.527; P = 0.294), Qmax (P = 0.776; P = 0.420), PVR (P = 0.745; P = 0.607), and PV (P = 0.527; P = 0.573) between the groups at three and six months after surgery. No serious complications occurred in either group. CONCLUSION: US-TPLA and PAE seem to have a similar short-term efficacy. The efficacy of the two procedures is comparable, and neither is associated with serious complications. US-TPLA and PAE are both effective complementary measures for the treatment of BPH.

CRISPR-Cas13: A new technology for the rapid detection of pathogenic microorganisms.

Pathogenic microorganisms have major impacts on human lives. Rapid and sensitive diagnostic tools are urgently needed to facilitate the early treatment of microbial infections and the effective control of microbial transmission. CRISPR-Cas13 employs programmable RNA to produce a sensitive and specific method with high base resolution and thus to provide a novel tool for the rapid detection of microorganisms. The review aims to provide insights to spur further development by summarizing the characteristics of effectors of the CRISPR-Cas13 system and by describing the latest research into its application in the rapid detection of pathogenic microorganisms in combination with nucleic acid extraction, isothermal amplification, and product detection.

High-temperature stability in air of Ti3C2Tx MXene-based composite with extracted bentonite.

Although Ti3C2Tx MXene is a promising material for many applications such as catalysis, energy storage, electromagnetic interference shielding due to its metallic conductivity and high processability, it's poor resistance to oxidation at high temperatures makes its application under harsh environments challenging. Here, we report an air-stable Ti3C2Tx based composite with extracted bentonite (EB) nanosheets. In this case, oxygen molecules are shown to be preferentially adsorbed on EB. The saturated adsorption of oxygen on EB further inhibits more oxygen molecules to be adsorbed on the surface of Ti3C2Tx due to the weakened p-d orbital hybridization between adsorbed O2 and Ti3C2Tx, which is induced by the Ti3C2Tx/EB interface coupling. As a result, the composite is capable of tolerating high annealing temperatures (above 400 °C for several hours) both in air or humid environment, indicating highly improved antioxidation properties in harsh condition. The above finding is shown to be independent on the termination ratio of Ti3C2Tx obtained through different synthesis routes. Utilized as terahertz shielding materials, the composite retains its shielding ability after high-temperature treatment even up to 600 °C, while pristine Ti3C2Tx is completely oxidized with no terahertz shielding ability. Joule heating and thermal cycling performance are also demonstrated.

The association of AT-III and D-Dimer with unexplained recurrent spontaneous abortion and their diagnostic value for prethrombotic state.

OBJECTIVE: This study aimed to investigate the role of antithrombin III (AT-III) and D-dimer (D-Dimer) in patients with unexplained recurrent spontaneous abortion (URSA); Methods: Sixty pregnant women with URSA (AEP group), 80 non-pregnant women with a history of URSA (ANP group), 50 healthy women in early pregnancy (NEP group) and 50 healthy non-pregnant women (NNP group) were retrospectively enrolled. Their serum AT-III and D-Dimer levels were measured. The patients in the ANP group were divided into three subgroups according to the number of miscarriages: 3 miscarriages (32 cases), 4 miscarriages (22 cases), and >4 miscarriages (26 cases), and the differences in serum AT-III and D-Dimer levels among these subgroups were compared. The patients in the AEP group were monitored for changes in AT-III and D-Dimer levels, and finally the diagnostic value of AT-III and D-Dimer levels were calculated for the prethrombotic state of URSA. RESULTS: (1) AT-III and D-Dimer levels differed significantly among the 4 groups (P<0.05); (2) As the number of miscarriages increased, D-Dimer levels elevated and AT-III levels decreased, with significant differences among three subgroups (P<0.05); (3) As the treatment proceeded, patients in AEP and ANP groups showed a tendency for a gradual increase in AT-III levels and a significant decrease in D-Dimer levels, with significant differences before and after treatment (P<0.05); (4) The diagnostic AUC of AT-III and D-Dimer in the prediction of prethrombotic state of URSA were 0.8922 (95% CI=0.8026-0.9819, P<0.0001) and 0.8776 (95% CI=0.7643-0.9909, P<0.0001). CONCLUSION: AT-III and D Dimer levels are closely associated with URSA. The results of this study have preliminarily confirmed the feasibility of applying AT-III and D Dimer to screen the prethrombotic state of URSA, and their clinical application will help provide a reference for determining the cause of miscarriage in the infertile population with URSA and facilitate successful pregnancy.

Ultrasound grayscale ratio: a reliable parameter for differentiating between papillary thyroid microcarcinoma and micronodular goiter.

BACKGROUND: The present study aimed to quantify and differentiate the echo levels of papillary thyroid microcarcinomas (PTMCs) and micronodular goiters (MNGs) using the ultrasound grayscale ratio (UGSR) and to investigate the repeatability of UGSR. METHODS: The ultrasound (US) data of 241 patients with 265 PTMCs and 141 patients with 168 MNGs confirmed by surgery and pathology were retrospectively analyzed. All patients had received outpatient ultrasonic examination and preoperative ultrasonic positioning. The RADinfo radiograph reading system was used to measure the grayscales of PTMC, MNG, and thyroid tissues at the same gain level, and the UGSR values of the PTMC, MNG, and thyroid tissue were calculated. The patients were divided into outpatient examination, preoperative positioning, and mean value groups, and the receiver operating characteristic (ROC) curves were calculated to obtain the optimal UGSR threshold to distinguish PTMC from MNG. The interclass correlation coefficient (ICC) was used to assess the consistency of UGSR measured in three groups. RESULTS: The UGSR values of the PTMC and MNG were 0.56 ± 0.14 and 0.80 ± 0.19 (t = 5.84, P < 0.001) in the outpatient examination group, 0.55 ± 0.14 and 0.80 ± 0.19 (t = 18.74, P < 0.001) in the preoperative positioning group, and 0.56 ± 0.12 and 0.80 ± 0.18 (t = 16.49, P < 0.001) in the mean value group. The areas under the ROC curves in the three groups were 0.860, 0.856, and 0.875, respectively. When the UGSR values for the outpatient examination, preoperative positioning, and mean value groups were 0.649, 0.646, and 0.657, respectively, each group obtained its largest Youden index. A reliable UGSR value was obtained between the outpatient examination and preoperative positioning groups (ICC = 0.79, P = 0.68). CONCLUSION: UGSR is a simple and repeatable method to distinguish PTMC from MNG, and hence, can be widely applicable.

Prospective Evaluation of Ultrasound in a Novel Position with MRI Virtual Navigation for MRI-Detected Only Breast Lesions: A Pilot Study of a More Efficient and Economical Method.

The aim of this study was to evaluate the clinical utility of ultrasound (US) with magnetic resonance imaging (MRI) virtual navigation in a novel prone position for MRI-detected incidental breast lesions. Between June 2016 and June 2020, 30 consecutive patients with 33 additional Breast Imaging Reporting and Data System (BI-RADS) category 4 or 5 lesions that were detected on MRI but occult on second-look US were enrolled in the study. All suspicious lesions were located in real-time US using MRI virtual navigation in the prone position and then followed by US-guided biopsy or surgical excision. Pathological results were taken as the standard of reference. The detection rate of US with MRI virtual navigation was calculated. The MRI features and pathological types of these lesions were analyzed. A total of 31 lesions were successfully located with real-time US with MRI virtual navigation and then US-guided biopsy or localization, and the detection rate was 93.9% (31/33). Twenty-seven (87.1%, 27/31) proved to be benign lesions and four (12.9%, 4/31) were malignant lesions at pathology. Of the 33 MRI-detected lesions, 31 (93.9%, 31/33) were non-mass enhancements and two (6.1%, 2/33) were masses. This study showed that real-time US with prone MRI virtual navigation is a novel efficient and economical method to improve the detection and US-guided biopsy rate of breast lesions that are detected solely on MRI.

Ultrasound-guided transperineal laser ablation for percutaneous treatment of benign prostatic hyperplasia: a new minimally invasive interventional therapy.

BACKGROUND: Although there are different treatments for benign prostate hyperplasia, their efficacy and safety differ. We are currently exploring a new minimally invasive interventional therapy for benign prostatic hyperplasia (BPH). PURPOSE: To determine the feasibility, effectiveness, and safety of ultrasound-guided transperineal laser ablation (US-TPLA) for the treatment of BPH. MATERIAL AND METHODS: Twenty patients with BPH (mean age = 73.9 ± 9.2 years) who underwent US-TPLA from June 2018 to January 2020 with a subsequent six-month follow-up were retrospectively reviewed. After local anesthesia, a 21-G trocar was inserted into the prostate tissue under ultrasound monitoring, followed by 1064 nm diode laser irradiation. Changes in international prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume, and complications were evaluated six months after surgery. RESULTS: All patients underwent the operation successfully without serious complications. After six months, the average IPSS improved from 22.7 ± 5.3 to 9.1 ± 3.2 (P < 0.001), the QoL improved from 4.9 ± 1.7 to 2.3 ± 1.3 (P < 0.001), the Qmax improved from 8.5 ± 3.0 to 15.2 ± 4.8 mL/s (P < 0.001), the PVR increased from 78.7 ± 58.8 to 30.3 ± 34.2 (P < 0.05), and the mean prostate volume ranged from 70.8 ± 23.8 to 54.7 ± 20.9 mL (P < 0.05). CONCLUSION: US-TPLA is safe and feasible for the treatment of BPH. An evaluation at the six-month follow-up is effective.

The Improvement in Hydrogen Storage Performance of MgH2 Enabled by Multilayer Ti3C2.

MgH2 has become a hot spot in the research of hydrogen storage materials, due to its high theoretical hydrogen storage capacity. However, the poor kinetics and thermodynamic properties of hydrogen absorption and desorption seriously hinder the development of this material. Ti-based materials can lead to good effects in terms of reducing the temperature of MgH2 in hydrogen absorption and desorption. MXene is a novel two-dimensional transition metal carbide or carbonitride similar in structure to graphene. Ti3C2 is one of the earliest and most widely used MXenes. Single-layer Ti3C2 can only exist in solution; in comparison, multilayer Ti3C2 (ML-Ti3C2) also exists as a solid powder. Thus, ML-Ti3C2 can be easily composited with MgH2. The MgH2+ML-Ti3C2 composite hydrogen storage system was successfully synthesized by ball milling. The experimental results show that the initial desorption temperature of MgH2-6 wt.% ML-Ti3C2 is reduced to 142 °C with a capacity of 6.56 wt.%. The Ea of hydrogen desorption in the MgH2-6 wt.% ML-Ti3C2 hydrogen storage system is approximately 99 kJ/mol, which is 35.3% lower than that of pristine MgH2. The enhancement of kinetics in hydrogen absorption and desorption by ML-Ti3C2 can be attributed to two synergistic effects: one is that Ti facilitates the easier dissociation or recombination of hydrogen molecules, while the other is that electron transfer generated by multivalent Ti promotes the easier conversion of hydrogen. These findings help to guide the hydrogen storage properties of metal hydrides doped with MXene.

Obstacle Avoidance of Multi-Sensor Intelligent Robot Based on Road Sign Detection.

The existing ultrasonic obstacle avoidance robot only uses an ultrasonic sensor in the process of obstacle avoidance, which can only be avoided according to the fixed obstacle avoidance route. Obstacle avoidance cannot follow additional information. At the same time, existing robots rarely involve the obstacle avoidance strategy of avoiding pits. In this study, on the basis of ultrasonic sensor obstacle avoidance, visual information is added so the robot in the process of obstacle avoidance can refer to the direction indicated by road signs to avoid obstacles, at the same time, the study added an infrared ranging sensor, so the robot can avoid potholes. Aiming at this situation, this paper proposes an intelligent obstacle avoidance design of an autonomous mobile robot based on a multi-sensor in a multi-obstruction environment. A CascadeClassifier is used to train positive and negative samples for road signs with similar color and shape. A multi-sensor information fusion is used for path planning and the obstacle avoidance logic of the intelligent robot is designed to realize autonomous obstacle avoidance. The infrared sensor is used to obtain the environmental information of the ground depression on the wheel path, the ultrasonic sensor is used to obtain the distance information of the surrounding obstacles and road signs, and the information of the road signs obtained by the camera is processed by the computer and transmitted to the main controller. The environment information obtained is processed by the microprocessor and the control command is output to the execution unit. The feasibility of the design is verified by analyzing the distance acquired by the ultrasonic sensor, infrared distance measuring sensors, and the model obtained by training the sample of the road sign, as well as by experiments in the complex environment constructed manually.

Emerging Topochemical Strategies for Designing Two-Dimensional Energy Materials.

The unique properties of two-dimensional (2D) materials make them increasingly attractive in various fields, especially for energy harvesting, conversion, or storage. Simultaneously, numerous synthetic methods have been rapidly developed. Recently, topochemical strategies were demonstrated, and they show tremendous promising potential for synthesizing 2D materials due to their simplicity, scalability, and high efficiency. Considering the suitability of material structures and their synthesis methods, as well as the relationship between material properties and applications, it is necessary for researchers to comprehensively review and determine the prospects of 2D materials based on topological chemical synthesis methods and their related applications. Therefore, in this review, we systematically summarize and analyze the representative topochemical strategies for synthesizing 2D materials, including salt-templating methods for non-layered 2D materials, molten Lewis acid etching strategy for novel MXenes, and the chalcogen vapors etching and substituting strategy for phase-controlled 2D materials and so on, with the application of these 2D materials in energy-related fields including batteries, supercapacitors, and electrocatalysis. At the end of the paper, the corresponding perspective was also illustrated, and we expect that this could provide a reference for the future research in the field.

Design and Research of All-Terrain Wheel-Legged Robot.

Aiming at the crossing problem of complex terrain, to further improve the ability of obstacles crossing, this paper designs and develops an all-terrain wheel-legged hybrid robot (WLHR) with strong adaptability to the environment. According to the operation requirements in different road conditions, the robot adopts a wheel and leg compound structure, which can realize the transformation of wheel movement and leg movement to adjust its motion state. The straight and turning process of the robot is analyzed theoretically, the kinematics model is established and solved, and obstacle crossing analysis is carried out by establishing the mathematical model of front wheel obstacle crossing when the robot meets obstacles. To verify the analysis results, ADAMS software is used to simulate and analyze the process of robot running on the complex road surface and obstacles-crossing. Finally, a theoretical prototype is made to verify its feasibility. Theoretical analysis and experimental results show that the designed WLHR is feasible and has the stability of the wheeled mechanism and the higher obstacle crossing ability of the legged mechanism so that the robot can adapt to a variety of complex road conditions.

Imaging manifestations of Caroli disease with autosomal recessive polycystic kidney disease: a case report and literature review.

BACKGROUND: Both Caroli disease (CD) and autosomal recessive polycystic kidney disease (ARPKD) are autosomal recessive disorders, which are more commonly found in infants and children, for whom surviving to adulthood is rare. Early diagnosis and intervention can improve the survival rate to some extent. This study adopted the case of a 26-year-old pregnant woman to explore the clinical and imaging manifestations and progress of CD concomitant with ARPKD to enable a better understanding of the disease. CASE PRESENTATION: A 26-year-old pregnant woman was admitted to our hospital for more than 2 months following the discovery of pancytopenia and increased creatinine. Ultrasonography detected an enlarged left liver lobe, widened hepatic portal vein, splenomegaly, and dilated splenic vein. In addition, both kidneys were obviously enlarged and sonolucent areas of varying sizes were visible, but color Doppler flow imaging revealed no abnormal blood flow signals. The gestational age was approximately 25 weeks, which was consistent with the actual fetal age. Polyhydramnios was detected but no other abnormalities were identified. Magnetic resonance imaging revealed that the liver was plump, and polycystic liver disease was observed near the top of the diaphragm. The T1 and T2 weighted images were the low and high signals, respectively. The bile duct was slightly dilated; the portal vein was widened; and the spleen volume was enlarged. Moreover, the volume of both kidneys had increased to an abnormal shape, with multiple, long, roundish T1 and T2 abnormal signals being observed. Magnetic resonance cholangiopancreatography revealed that intrahepatic cystic lesions were connected with intrahepatic bile ducts. The patient underwent a genetic testing, the result showed she carried two heterozygous mutations in PKHD1. The patient was finally diagnosed with CD with concomitant ARPKD. The baby underwent a genetic test three months after birth, the result showed that the patient carried one heterozygous mutations in PKHD1, which indicated the baby was a PKHD1 carrier. CONCLUSIONS: This case demonstrates that imaging examinations are of great significance for the diagnosis and evaluation of CD with concomitant ARPKD.

Therapeutic effect of high-frequency ultrasound-assisted dye laser on hemangioma and its influence on serum HIF-1α in patients.

BACKGROUND: To analyze the therapeutic effect of high-frequency ultrasound (HFU)-assisted dye laser on hemangioma patients and changes in serum hypoxia-inducible factor-1α (HIF-1α). METHODS: A total of 20 patients diagnosed with hemangioma in our hospital from January 2013 to March 2018 were selected, including 12 males and eight females. All patients were treated with HFU-assisted dye laser. The site and type of hemangioma and age distribution of patients were collected, and changes in data and area of hemangioma and serum HIF-1α before and after treatment were analyzed. RESULTS: The vascular condition of hemangioma in all patients was significantly improved at 7, 14, and 30 days after treatment. Gray-scale ultrasound displayed that the tumor area was reduced by more than 50%. After treatment, the serum HIF-1α level declined obviously after treatment compared with that before treatment, showing a statistically significant difference (P < 0.05). CONCLUSION: HFU-assisted dye laser can effectively reduce the tumor area, decrease the serum HIF-1α level, and improve the prognosis in the treatment of hemangioma.

Dermatofibrosarcoma metastases to the pancreas: A case report.

BACKGROUND: In general, malignant tumors metastasize to the pancreas in < 1% of cases. Most patients miss the opportunity for further surgery due to distant metastases; however, for fibrosarcomas, aggressive surgery may be helpful even if distant metastases occur. Hence, we report such a case and share some valuable information about the disease. CASE SUMMARY: A 45-year-old man was admitted with recurrent epigastric pain for 10 days. The abdominal pain was mainly related to bloating with nausea, but no other associated symptoms. No particular signs were found on abdominal examination or laboratory testing. In 2003, a local distal expanded resection of the primary fibrosarcoma in the left chest wall was performed. Then, a left pneumonectomy was performed in 2017 due to diffuse metastases from the fibrosarcoma to the left lung. Enhanced computed tomography (CT) and magnetic resonance imaging of the upper abdomen suggested multiple masses of different sizes involving the head and tail of the pancreas; no local lymph node enlargement was noted. The postoperative pathologic diagnosis revealed a fibrosarcoma of the pancreas. A CT re-examination 6 mo postoperatively showed no local recurrence or distant metastases. CONCLUSION: A fibrosarcoma is a rare low-grade malignant tumor, and metastases to the pancreas are even rarer. Patients with a history of a fibrosarcoma should consider the possibility of metastasis when a pancreatic neoplasm is demonstrated. Surgical resection is the preferred treatment.