Undifferentiated (Anaplastic) Carcinoma of the Pancreas with Osteoclast-Like Giant Cells Showing Various Degree of Pancreas Duct Involvement. A Case Report and Literature Review

摘要

Context Undifferentiated (anaplastic) carcinomaof the pancreas with osteoclast-like giant cells is exceedingly rare. The prognosisof undifferentiated carcinoma is worse than that of poorly differentiated ductaladenocarcinoma of the pancreas; however, undifferentiated carcinoma with osteoclast-likegiant cells might have a more favorable prognosis. Case report We reportthe case of undifferentiated carcinoma of the pancreas with osteoclast-like giantcells, showing an intraductal growth pattern with various degree of pancreas ductinvolvement in the different areas. As a result, we were able to demonstrate theentire spectrum of changes, ranging from the early, minimal intraluminal growthto the partial or complete occlusion of the branches of the main pancreatic duct,and finally invasion and formation of the large necrotic/degenerated cysts. ConclusionsOur findings support the epithelial origin of undifferentiated carcinoma of thepancreas with osteoclast-like giant cells. In early stages, the affected pancreaticduct epithelium was intermingled with nonepithelial component and had an immunoprofiledistinctive from the epithelial lining of the uninvolved (normal) pancreatic ducts.Distinctive immunoprofile (CK 5/6, p63 and p53 positive) of the epithelial componentand p63 and p53 positivity of the nonepithelial component should be explained andfurther investigated in the similar cases. Our findings support prior assertionsthat undifferentiated carcinoma of the pancreas with osteoclast-like giant cellsmay develop from carcinoma in situ within the main pancreatic duct or its branches.