Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells reported in an asymptomatic patient: a rare case and literature review

Abstract

Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UC-OGC) is a rare and poorly described pancreatic malignancy. It is comprised of mononuclear, pleomorphic, and undifferentiated cells as well as osteoclast-like giant cells (OGC’s). It constitutes less than 1% of pancreatic non-endocrine neoplasia and is twice as likely to occur in females as in males. Its histopathologic properties remain poorly understood. It is suspected that UC-OGC is of epithelial origin that can then transition to mesenchymal elements. As part of this study, we describe a case of a malignant pancreatic neoplasm that was discovered in a 69-year old patient as an incidental finding. We also provide an overview of previously published data to highlight UC-OGC’s clinical and pathologic features.

Imaging features of undifferentiated carcinoma of the pancreas

“…However, such findings were not observed in the present series. In contrast, as observed in the present series, serum tumour markers, including CEA and CA19‐9, were less likely to be elevated in patients with UCP compared with patients with pancreatic adenocarcinoma …”

Huge and recurrent undifferentiated carcinoma with osteoclast-like giant cells of the pancreas

“…MRI demonstrated a well-demarcated, heterogeneous cystic tumor with prominent enhancement of the septations and the capsule in our case. The previous studies also reported that lymph nodes involvement is less common in UCOGCPs (7,8). Indeed, our case also showed no obvious lymph node involvement.…”

“…Since the growth of tumor is very rapid in a short period of time, UCOGCP often appears as a heterogeneous mass with distinct hemorrhage and necrosis. An inhomogeneous appearance with cystic structures and nonuniform enhancement is the typical radiological finding of UCOGCP (5,6). MRI demonstrated a well-demarcated, heterogeneous cystic tumor with prominent enhancement of the septations and the capsule in our case.…”

Undifferentiated carcinoma with osteoclastic giant cells of the pancreas diagnosed by endoscopic ultrasound guided biopsy

“…Different treatments have been reported, surgical resection being the choice in the early stages. Cases of patients treated with different schemes of adjuvant chemotherapy have also been reported [ 3 , 17 – 20 ]. In addition, a case of UC-OGC with liver metastasis treated with radiofrequency ablation and chemotherapy has been published [ 18 ].…”