Undifferentiated carcinoma with osteoclast‐like giant cells of pancreas on cytology: A case report with review of literature

Abstract

Undifferentiated carcinoma with osteoclast‐like giant cells (UC‐OGC) is a rare malignant neoplasm accounting for <1% of pancreatic masses. Very few case reports and small series have described the cytomorphological features of this entity. We report a case of UC‐OGC arising in the pancreas presenting with liver metastasis in a 56‐year‐old man diagnosed by guided fine‐needle aspiration cytology (FNAC). A characteristic biphasic pattern comprising of malignant mononuclear cells with scattered bland giant cells were the hallmark features for cytological diagnosis. Our case along with review of cytology literature emphasize the utility of FNAC and the cell block in the diagnosis and management of this rare entity.

Classification of endoscopic ultrasound guided fine needle aspiration cytology of pancreatic space occupying lesions by Papanicolaou Society of Cytopathology System: A five year study

“…Presence of squamous differentiation in a conventional adenocarcinoma imparts a poorer prognosis. A rare case of undifferentiated carcinoma with osteoclastic giant cells (UG–OGC) of pancreas was also reported 19 . UC–OGC of the pancreas is a rare and aggressive entity, accounting for less than 1.4% of all pancreatic malignancies.…”

Cytologic, histologic, and molecular features of pancreatic sarcomatoid undifferentiated carcinoma with heterologous osteosarcomatous transformation

“…Of the 23 reported cases diagnosed by cytology, most had easily recognizable osteoclast-like giant cells on the FNA specimen and many were associated with a conventional ductal adenocarcinoma component. 8,9 While these studies raised the limitation of small FNA samples for definitive diagnosis in some cases, they also acknowledged that FNA was capable of rendering pre-operative diagnoses that led to prompt surgical resection, which offers the best chance for cure in these patients.…”

“…In contrast, undifferentiated carcinoma with osteoclast‐like giant cells, another subtype that has been diagnosed on cytology given its characteristic cytomorphologic features, is composed of neoplastic mononuclear cells and non‐neoplastic osteoclast‐like multinucleated giant cells. Of the 23 reported cases diagnosed by cytology, most had easily recognizable osteoclast‐like giant cells on the FNA specimen and many were associated with a conventional ductal adenocarcinoma component 8,9 . While these studies raised the limitation of small FNA samples for definitive diagnosis in some cases, they also acknowledged that FNA was capable of rendering pre‐operative diagnoses that led to prompt surgical resection, which offers the best chance for cure in these patients.…”