A male case of an undifferentiated carcinoma with osteoclast-like giant cells originating in an indeterminate mucin-producing cystic neoplasm of the pancreas. A case report and review of the literature

Wada, Toshimi; Itano, Osamu; Oshima, Go; Chiba, Naokazu; Ishikawa, Hideki; Koyama, Yasumasa; Du, Wei; Kitagawa, Yuko

doi:10.1186/1477-7819-9-100

Cited by 28 publications

(27 citation statements)

References 15 publications

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“…Only three case reports described that the cysts in the tumors were lined by normal or atypical epithelial cells and formed a single cell layer. In addition, some authors have reported cases of ACP associated with mucinous cystic neoplasms[ 17 - 19 ], although the occurrence of histogenesis of ACP coincident with mucinous cystic neoplasm remains uncertain. These cases appear to display similar imaging findings to those of other forms of ACP with extensive cystic degeneration; however, in the present review, there were no reported cases of ACP coincident with mucinous cystic neoplasm in the lesion.…”

Section: Discussionmentioning

confidence: 99%

Anaplastic carcinoma of the pancreas: Case report and literature review of reported cases in Japan

Hoshimoto¹,

Matsui²,

Miyata³

et al. 2016

WJG

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We report a case of a 64-year-old woman with anaplastic carcinoma of the pancreas (ACP) with cyst formation and review 60 ACP cases reported in Japan. In 20% of cases, laboratory tests revealed severe anemia (hemoglobin level < 10.0 g/dL) and elevated leucocyte counts (> 12000/mm3), which were likely attributable to rapid tumor growth, intratumoral hemorrhage, and necrosis. Elevated serum CA19-9 levels were observed in 55% of cases. Cyst-like structures were observed on imaging in 47% of cases, and this finding appears to reflect subsequent cystic degeneration in the lesion. Macroscopically, hemorrhagic necrosis was observed in 77% of cases, and cyst formation was observed in 33% of cases. ACP should be considered when diagnosing pancreatic tumors with a cyst-like appearance, especially in the presence of severe anemia, elevated leucocyte counts, or elevated serum CA19-9 levels.

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Section: Discussionmentioning

confidence: 99%

Anaplastic carcinoma of the pancreas: Case report and literature review of reported cases in Japan

Hoshimoto¹,

Matsui²,

Miyata³

et al. 2016

WJG

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“…Ours is the second case described in the english literature of an indeterminate mucin-producting cystic neoplasm containing an area of undifferentiated carcinoma with osteoclast-like giant cells. In a review that analyzed all cases of MCN associated with OGCC, 10 of 12 patients were alive at follow-up [ 6 ]. By contrast our report was remarkable for the rapid progression of the tumor.…”

Section: Discussionmentioning

confidence: 99%

“…In 1981, Posen described for the first time the association of a giant cell tumor of the osteoclastic type with a mucous secreting cystic pancreatic neoplasm and since then only 12 cases have been reported [ 5 , 6 ]. In a recent review Wada et al analyzing all the cases in the literature, reported a favourable prognosis for this particular tumor association [ 6 ]. We present the second case in the literature of a patient with an indeterminate mucin-producting cystic neoplasm containing a single area of undifferentiated carcinoma with osteoclast- like giant cells, characterized by a rapid disease progression.…”

Section: Introductionmentioning

confidence: 99%

An indeterminate mucin-producing cystic neoplasm containing an undifferentiated carcinoma with osteoclast-like giant cells: a case report of a rare association of pancreatic tumors

et al. 2015

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BackgroundOnly few case reports of mucinous cystic pancreatic neoplasm containing an undifferentiated carcinoma with osteoclast-like giant cells have been described in the literature. In the majority of cases this unusual association of tumors seems related to a favorable outcome. We present the second case of an indeterminate mucin-producting cystic neoplasm containing an area of carcinoma with osteoclast-like giant cells. The specific features of the two histotypes and the rapid course of the disease make our clinical case remarkable.Case presentationA 68 year old female came to our attention for a pancreatic macrocystic mass detected with ultrasonography. Her past medical history was silent. The patient reported upper abdominal discomfort for two months; nausea, vomiting or weight loss were not reported. Physical examination revealed a palpable mass in the epigastrium; scleral icterus was absent. Cross-sectional imaging showed a complex mass of the neck and body of the pancreas, characterized by multiple large cystic spaces separated by thick septa and an area of solid tissue located in the caudal portion of the lesion. The patient underwent total pancreatectomy with splenectomy. Pathological examination revealed a mucinous cystic neoplasm with a component of an undifferentiated carcinoma with osteoclast-like giant cells. Because of the absence of ovarian-type stroma, the lesion was classified as an indeterminate mucin-producing cystic neoplasm of the pancreas. The immunohistochemical studies evidenced no reactivity of osteclast-like giant cells to epithelial markers but showed a positive reactivity to histiocytic markers. Numerous pleomorphic giant cells with an immunohistochemical sarcomatoid profile were present in the undifferentiated carcinoma with osteoclast-like giant cells. A rapid tumor progression was observed: liver metastases were detected after 4 months. The patient received adjuvant chemotherapy (Gemcitabine) but expired 10 months after surgery.ConclusionOur case confirms that the presence of a solid area in a cystic pancreatic tumor at cross-sectional imaging should raise a suspicion of malignant transformation. The lack of ovarian-type stroma in a pancreatic mucinous cystic neoplasm and the presence of pleomorphic giant cells in an undifferentiated carcinoma with osteoclast-like giant cells could be a marker of a poor prognosis.

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“…For example, some researchers have proposed that OGTP does not exhibit any sex-bias with respect to its development and that it has a relatively good prognosis as compared to other pancreatic tumors owing to the fact that OGTP typically only exhibits localized spreading, with metastasis to lymph nodes and distant sites being slow to develop and rarely reported [ 19 ]. In contrast, however, some researchers have reported OGTP to be more common in females [ 20 ] and to have a worse prognosis [ 21 , 22 ]. The site preferences for OGTP tumors similarly remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Prognosis of Osteoclast-like Giant Cell Tumors of the Pancreas Compared with Pancreatic Adenocarcinomas: A Population-Based Study

Chen²,

Wang

et al. 2020

Med Sci Monit

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Background The incidence of osteoclast-like giant cell tumor of the pancreas (OGTP) is very low, and relatively little OGTP clinical data is available. The present study, therefore, sought to conduct a more comprehensive analysis of the clinical characteristics and prognosis of OGTP. Material/Methods A large population-based cohort analysis was conducted using the Surveillance, Epidemiology and End Results (SEER) registry. We conducted a systematic assessment of the demographic and clinical characteristics of these patients, in addition to assessing available prognostic and therapeutic data corresponding to their disease. We further compared overall survival (OS) in these OGTP and pancreatic adenocarcinoma (PA) patient cohorts, adjusting for sex, grade, stage, and surgical treatment by propensity score matching (PSM). Results We included a total of 47 OGTP patients and 73 150 PA patients in the present analysis. The mean ages of PA and OGTP diagnosis were 68.0 and 62.8 years, respectively. Compared with PA patients, OGTP patients were more likely to be female (70.2% versus 48.7%, P <0.01), to have early-stage disease, to have lower rates of lymph node metastasis (17.0% versus 28.8%, P <0.01) and distant metastasis (17.0% versus 45.1%, P <0.01), and to have higher rates of tumor resection (70.2% versus 15.4%, P <0.01). OGTP patients also had a significantly longer median OS than did PA patients (13 months versus 6 months; hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.37–0.57, P <0.0001). No significant differences in tumor site preferences were detected. Our findings also suggested that being female, having early-stage disease, and undergoing surgical resection may be associated with a more favorable prognosis in patients with OGTP. Conclusions OGTP patients had distinctive clinical characteristics and a better prognosis compared with PA patients. Understanding these differences will help clinicians accurately recognize these diseases. Radical resection was beneficial to the survival of OGTP patients.

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A male case of an undifferentiated carcinoma with osteoclast-like giant cells originating in an indeterminate mucin-producing cystic neoplasm of the pancreas. A case report and review of the literature

Cited by 28 publications

References 15 publications

Anaplastic carcinoma of the pancreas: Case report and literature review of reported cases in Japan

Anaplastic carcinoma of the pancreas: Case report and literature review of reported cases in Japan

An indeterminate mucin-producing cystic neoplasm containing an undifferentiated carcinoma with osteoclast-like giant cells: a case report of a rare association of pancreatic tumors

Clinical Characteristics and Prognosis of Osteoclast-like Giant Cell Tumors of the Pancreas Compared with Pancreatic Adenocarcinomas: A Population-Based Study

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