A pancreatic mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) (NET and undifferentiated carcinoma of the pancreas with osteoclast-like giant cells) with metastatic neuroendocrine component to the liver

Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UCOGCs) is an extremely rare morphologically and clinically distinct variant of pancreatic ductal adenocarcinoma (PDAC), exhibiting a characteristic component of reactive osteoclast-like giant cells admixed with neoplastic mononuclear cells. Sommers and Meissner first described it in 1954 as an "unusual carcinoma of the pancreas". Later it acquired many different names. In 2010, the WHO classified these tumors as a variant of PDAC under the heading of "undifferentiated carcinoma with osteoclast-like giant cells". Here we describe the first case of pancreatic mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) composed of UCOGC and pancreatic neuroendocrine tumor (NET), which occurred in a 78-year-old man with biliary colic and pancreatitis. The mass did not respond to the chemotherapy, and he soon developed liver metastasis from the NET component, and unfortunately, the patient passed away 10 months later. Since UCOGC is extremely rare, and its association with NET has not been reported yet, our case expands the knowledge regarding its unusual presentation and poor prognosis.

Clinical characteristics of adenosquamous carcinoma of the pancreas: A case-control study / 中国肿瘤临床

Objective: To analyze the clinical characteristics of adenosquamous carcinoma of the pancreas (ACP) and pancreatic ductal adenocarcinoma (PDA), and to explore the differences in prognosis between the two types. Methods: The clinical and pathological characteristics of 26 cases with ACP (Group A) and another 26 with PDA (Group B), both of whom underwent radical surgery at Tianjin Medical University Cancer Hospital from August 2014 to April 2019, were retrospectively analyzed, and were matched according to the ratio of one to one. In our study, the characteristics of each pair included preoperative ECOG score, age, gender, the location and size of the tumors, TNM staging, CA19-9, CEA. The prognostic differences between the two groups were compared and analyzed. Results: There were 7 females and 19 males in both groups, among which 12 had lesions in the head of the pancreas and 14 in the tail of the pancreas; TNM staging: 13 in stageb, 6 in stage Ⅱa, 6 in stage Ⅱb, and 1 in stage III. The average tumor size was 3.9 cm in the Group B, and 4.4 cm in the Group A. Radical surgery was performed in the patients of both groups, and among them 7 patients in Group A received combined organ resections. Survival analysis showed that the median survival time was 8.5 months in Group A and 19 moths in Group B (HR: 0.442; 95% CI: 0.224-0.872; P=0.019). Conclusions: ACP is more common in the males and its The prognosis is worse compared with PDA, but it has no specific clinical manifestations.

Poliartrite e nódulos subcutâneos como primeira manifestação de carcinoma de pâncreas / Polyarthritis and subcutaneous nodules as first manifestation of carcinoma of pancreas

A associação de poliartrite, nódulos subcutâneos e carcinoma de pâncreas é uma condição rara e pouco diagnosticada. O presente trabalho tem o objetivo de relatar um caso de carcinoma pancreático associado a poliartrite e nódulos subcutâneos, semelhantes ao eritema nodoso, cujo exame histopatológico evidenciou tratar-se de paniculite com necrose gordurosa. Os autores pretendem, por meio deste relato, lembrar essa associação incomum que se torna de grande importância clínica, considerando que artrite e nódulos subcutâneos podem anteceder as manifestações clínicas de neoplasia pancreática.

The association of polyarthritis, subcutaneous nodules and carcinoma of the pancreas is a rare and underdiagnosed condition. The present work aims to report a case of a patient with carcinoma of pancreas associated with polyarthritis and subcutaneous nodules, similar to erythema nodosum, with histopathological findings of panniculitis with fat necrosis. The authors emphasize the importance of this uncommon association, considering that polyarthritis and subcutaneous nodules may appear before the clinical manifestations of the carcinoma of the pancreas.

The Clinical Meaning Of P～(27kipl)and carcinoma of the pancreas / 医学研究杂志

P～ 27 gene that has been found in recent years can inhibit cancer.It codes P～ 27 protein named CDKI.CDKI plays an important role in regulating the cell cycle.The symptom of carcinoma of the pancreas in early stage isn't distinctiveness.Once it is found,it has been in later stage.To explore the biological meaning of P～ 27kipl and carcinoma of the pancreas,we measure the expression of P～ 27kipl protein in carcinoma of the pancreas and normal pancreas tissue by using the method of immune tissue chemistry SP.

Surgical Outcome of Ductal Adenocarcinoma of the Body and Tail of the Pancreas / 한국간담췌외과학회지

PURPOSE: The prognosis of a ductal adenocarcinoma of the body and tail of the pancreas is poor because it is usually diagnosed at an advanced stage and is rarely resectable. The aim of this study was to evaluate the clinical outcomes after a surgical resection of an adenocarcinoma of the distal pancreas. METHODS: A total of 311 patients with an adenocarcinoma of the distal pancreas were admitted between 1985 and 2001, and of these, 54 patients were surgically treated; 29 patients underwent a distal pancreatectomy (extended resection in 12 cases), 9 underwent a palliative bypass, and 16 underwent a open biopsy. The clinical outcome of the 29 patients who underwent a surgical resection for the adenocarcinoma of the distal pancreas was retrospectively analyzed. RESULTS: The resectability rate was 9.3% (29/311). In the resected cases, the cumulative 3-year survival rate was 14.9%, whereas it was 0% (p=0.013) in the non-resected cases. Moreover, a significant survival difference was found between the curatively resected cases (n=16, 28.1%) and the palliatively resected cases (n=13, 0%)(p=0.003). After the curative resection, 11 patients (68.8%) developed a recurrence. Three patients survived more than 3 years (46, 74, 56 months), of whom only one had no recurrent disease. The size of the tumor and the residual tumor were identified as independent significant prognostic factors by multivariate analysis. CONCLUSION: Only a curative resection can offer long-term survival as well as a survival benefit in patients with a ductal adenocarcinoma of the body and tail of the pancreas. Therefore, a surgical resection should be preferably performed and efforts for a curative resection should be made. However, adjuvant therapy, local and systemic, needs to be further developed because most patients develop a recurrence after the resection.

Treatment of advanced pancreatic carcinoma with hand-assisted laparoscopic cholecystojejunostomy and gastroenterostomy combined with ~(125)I seed implantation / 中国微创外科杂志

Objective To assess the feasibility and clinical effect of hand-assisted laparoscopic cholecystojejunostomy and gastroenterostomy combined with()~(125)I seed implantation for the treatment of advanced pancreatic carcinoma.Methods Hand-assisted laparoscopic cholecystojejunostomy and gastroenterostomy combined with()~(125)I seed implantation was performed in 12 patients with advanced pancreatic carcinoma(pancreatic head,10 patients;pancreatic body,2 patients) between February 2002 and August 2004 in this hospital.Results All the operations were successfully accomplished.The operative time was 104~181 min(122?29 min),the operative blood loss was 45~152 ml(60?18 ml),and the length of hospital stay, 6~17 d(8.5?1.3 d).Postoperatively,the jaundice subsided gradually,and the patient's liver functions recovered to normal in 7~10 days.The abdominal pain disappeared in 3 patients and was obviously remitted in 7.Gastrointestinal dysfunction occurred in 2 patients and was cured with symptomatic therapy.Follow-up checkups with CT scannings in 10 patients for 6 months showed partial remission(PR) in 4 patients,no changes(NC) in 4 patients,and progressed disease(PD) in 2.Conclusions Hand-assisted laparoscopic internal drainage combined with()~(125)I seed implantation for the treatment of advanced pancreatic carcinoma is effective and micro-invasive.

Treatment of Locally Advanced Pancreatic Cancer / 대한치료방사선과학회지

From January 1981 to December 1991, forty patients with localized advanced carcinoma of the pancreas were treated at the Department of Therapeutic Radiology, Seoul National University Hospital. The treatment protocol consisted of two split course external radiation therapy with each 2000 cGy over two weeks separated by two week rest period. Intravenous 5-fluorouracil (5-FU) was administered on the first three days of each radiotherapy course. Twenty three of these patients were treated by maintenance 5-FU or FAM (5-FU, adriamycin, mitomycin) chemotherapy. Median survival was 9 months and the 2-year survival rate was 10.0%. Good prognostic indicators were good performance status, palliative bypass surgery and tumor located in the head of pancreas.

Prediction of Chemosensitivity Test on Human Pancreatic Carcinoma Cells of Short-Term Culture in Vitro / 昆明医科大学学报

In this paper the experimental study and clinical preliminary observation of chemosensitivity test on 5 cases of pancreatic carcinoma in vitro are reported. The major drug of clinical treatment of pancreatic carcinoma was 5-FU. The results showed only two cases had good correlativity. The results of chemosensitivity test showed that drug sensitivity inten- sity was ordinally 5-FU, MMC, ADR and TSPA. A close correlation between clinical chemotherapy treatment and chemosensitivity test in vitro was found in 4 patients out of 5. The survival time was over one year and the clinical response rate was 80%. This method could help select drug for clinical treatment and specify the application of the drug, which will surely improve the survival rate.

Trearment of Locally Unresectable Carcinoma of the Pancreas / 대한치료방사선과학회지

From January, 1981 to December, 1985, 22 patients with locally unresectable carcininoma of the pancreas were treated in the Department of Therapeutic Radiology, Seoul National University Hospital, Radiation was given in two split courses; each consisting of 2000 cGy over two weeks sepatated by two-week rest period. 5-FU was administered on the first three days of each radiation therapy course. FAM (50fluorouracil, adriamycin, mitomycin) was administered for maintenance chemotherapy. For pain control, complete relief was obtained in 22%(4/18) of patients and partial relief in 39%(7/18). Median survival was 31 weeks. Pretreatment performance status was the only statistically significant prognostic factor.