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Autops. Case Rep ; 11: e2020201, 2021. tab, graf
Article in English | LILACS | ID: biblio-1142397


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.

Humans , Male , Aged , Pancreatic Neoplasms/pathology , Neuroendocrine Tumors , Carcinoma, Pancreatic Ductal/pathology , Giant Cells , Fatal Outcome
Article in Korean | WPRIM | ID: wpr-163927


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.

Adenocarcinoma , Biopsy , Carcinoma, Pancreatic Ductal , Humans , Multivariate Analysis , Neoplasm, Residual , Pancreas , Pancreatectomy , Prognosis , Recurrence , Retrospective Studies , Survival Rate