Adenosquamous Carcinoma Of The Pancreas: A Clinicopathologic Series Of 25 Cases

Kardon, David E.; Thompson, Lester D.�R.; Przygodzki, Ronald; Heffess, Clara S.

doi:10.1038/modpathol.3880332

Cited by 165 publications

(161 citation statements)

References 18 publications

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“…1,12 In the cases in which cystic transformation was reported, the tumors were found to have either pseudocystic changes [8][9][10][14][15][16][17][18][19][20] or simple cysts. 21 In our large series of pancreatic ductal adenocarcinomas, including their variants such as adenosquamous carcinoma and undifferentiated carcinoma, 8% of the tumors showed cystic features.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic ductal adenocarcinomas with cystic features: neither rare nor uniform

et al. 2005

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Cystic tumors of the pancreas are uncommon but important because of their diverse pathology and biology. Their wide spectrum also includes cystic variants of otherwise solid tumors, such as cystic endocrine tumors, cystic acinar cell carcinomas and ductal adenocarcinomas with cystic changes. In this study, we screened pancreatic ductal adenocarcinomas and their variants for macrocystic changes and determined the nature of the cysts (neoplastic vs non-neoplastic). Of 483 tumors 38 (8%) had cystic features. The largest group consisted of 24 pancreatic ductal adenocarcinomas showing a large-gland pattern with small cysts whose diameter varied between 0.5 and 1.8 cm. The epithelial lining of these cysts was generally positive for CEA (83%) and/or MUC1 (71%) and MUC5AC (74%). p53 was positive in 57% of the cases. The second group of cystic tumors (8/483) showed degenerative cystic cavities with diameters ranging between 1 and 6 cm. This group consisted of poorly differentiated pancreatic ductal adenocarcinomas, undifferentiated carcinomas with or without osteoclast-like giant cells and one adenosquamous carcinoma. In the third group of cystic tumors there were four pancreatic ductal adenocarcinomas containing tumor-related retention cysts. Their epithelial cells were positive for MUC5AC, but negative for CEA, MUC1 and p53. The fourth group consisted of two pancreatic ductal adenocarcinomas showing closely attached pseudocysts caused by tumor-associated pancreatitis. The results indicate that a considerable number of pancreatic ductal adenocarcinomas and their variants display cystic features and must therefore be considered in the differential diagnosis of cystic neoplasms of the pancreas. Moreover, not all of the cystic structures we observed were neoplastic in nature. They may also represent nonneoplastic changes, such as retention cysts and inflammatory pseudocysts.

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Section: Discussionmentioning

confidence: 99%

Pancreatic ductal adenocarcinomas with cystic features: neither rare nor uniform

et al. 2005

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“…3 Only one large series has described the clinical, pathologic and selective molecular markers of this type of pancreatic cancer. 4 Thus, a better understanding of this aggressive form of pancreatic cancer may aid in finding new molecular markers and targets for this disease.…”

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confidence: 99%

Adenosquamous carcinoma of the pancreas harbors KRAS2, DPC4 and TP53 molecular alterations similar to pancreatic ductal adenocarcinoma

et al. 2009

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Adenosquamous carcinoma of the pancreas is one of the most aggressive forms of pancreatic cancer. Molecular characterizations of this rare tumor subtype are sparse. Understanding the common molecular and pathologic features of pancreatic adenosquamous carcinomas could provide critical information for identifying therapeutic targets. Herein, we analyzed the pathologic and molecular features of our series of eight pancreatic adenosquamous carcinomas. We found KRAS2 gene mutations at codon 12 in all eight cases. All the cases showed loss of p16 protein. In three of these cases the loss was attributed to an exon 2 homozygous deletion in the p16/CDKN2a gene. The majority of the cases had loss of Dpc4 protein and strong nuclear p53 positivity, similar to the molecular signature found in pancreatic ductal adenocarcinoma. We found that E-cadherin was either lost or reduced in all cases and that epidermal growth factor receptor was overexpressed in all cases. The squamous component was positive for p63 staining and thus p63 labeling was helpful in identifying squamous differentiation in adenosquamous carcinomas with an acantholytic growth pattern. In summary, although pancreatic adenosquamous carcinoma and ductal adenocarcinoma have overlapping pathologic and molecular characteristics, there are distinct differences that may be helpful in diagnostic and therapeutic strategies.

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“…5 Ayrıca bu konuda çalışma yapan bir kısım araştırmacı, pankreasın pür skuamöz hücreli karsinomunda yeterli doku örnekle-mesi yapıldığında, tümör içinde adenokarsinom alanlarının mutlaka görüleceğini ve pür skuamöz hücreli karsinomların aslında adenoskuamöz karsinom olduğunu düşünmektedir. 5 Literatürde az sayıda seri ve olgu sunumları eş-liğinde bildirilen pankreas adenoskuamöz karsinomlarına ait en geniş seri, Boyd ve ark.na ait olup, ulusal kanser tarama programı kapsamında 1988-2007 yılları arasında pankreas malignitelerini taradıklarında; pankreas duktal adenokarsinomlu 45.693 hastayı saptamış ve bu hastaların 415 (%0,9)'inin pankreas adenoskuamöz karsinomlu olduğunu belirlemişlerdir. 3 Katz ve ark.…”

Section: Discussionunclassified

“…1,5,10 Moleküler ça-lışmalarda ise duktal adenokarsinomda kodon 12'de var olan KRAS mutasyonu, pankreas adenoskuamöz karsinomunda da gösterilmiştir. 1,5,10 Borazancı ve ark.nın çalışmasında kodon 12'nin yanı sıra kodon 13'te de KRAS mutasyonu saptanmış olup, bu bulgu adenoskuamöz karsinomun da duktal orijinli olduğunu düşündürmektedir. 1 Tedavisi ile ilgili tartışmalar devam etmekle birlikte, cerrahi sonrasında kemoterapi ve/veya radyasyon tedavisi önerilmektedir.…”

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