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Primary small cell carcinoma of the pancreas with an
unusual sonographic appearance.
J Clin Ultrasound.
2007 Feb;35(2):82-4.
We present a
case of primary pancreatic small cell carcinoma with an unusual
sonographic feature. A 75-year-old woman presented with poor
appetite and weight loss. Abdominal sonographic examination revealed
a diffusely enlarged pancreas with relative increased echogenicity
and smooth contour. CT also confirmed the diffuse infiltrative
pattern of the tumor. The diagnosis was confirmed via
sonographically guided biopsy. The tumor was composed of small cells
with hyperchromatic nuclei and scanty cytoplasm infiltrating the
pancreatic tissue, consistent with small cell carcinoma of the
pancreas. Primary pancreatic small cell carcinoma rarely presents as
the diffuse infiltrating type. These unusual sonographic features
must be differentiated from other pancreatic tumors presenting as
diffuse pancreatic enlargement.
Changes to levels
of serum neuron-specific enolase in a patient with small cell
carcinoma of the pancreas.
J Hepatobiliary Pancreat Surg. 2005; 12(1): 93-8.
Small cell
carcinoma (SCC) of the pancreas is a rare disease, with an extremely
poor prognosis; only 24 cases have been reported in the literature.
However, as some patients have been successfully treated with
combination chemotherapy, it is important to obtain both a definite
diagnosis and a precise evaluation of the effect of the treatment. A
69-year-old woman presented with an abdominal tumor and pain. She
had been observed for sensory neuropathy and swelling of the
pancreatic head by the referring doctor over the previous 9 months.
The patient was diagnosed with SCC of the pancreas after surgery and
had two courses of combination chemotherapy (cisplatin and etoposide).
Initially, the tumor disappeared completely on computed tomography
(CT) scans, but she died of disease recurrence 3 months after
completing the chemotherapy. Changes in serum neuron-specific
enolase (NSE) levels were monitored constantly during the progress
of the disease. NSE levels had already increased above the upper
limit of normal 8 months before the patient's admission to our
hospital, and levels changed concurrently not only with tumor growth
but also subsequently with remission and then relapse of the disease
after treatment. These results indicate that NSE is a good marker,
both as a diagnostic indicator for SCC of the pancreas and as a
means of evaluating response to treatment.
Poorly
differentiated small cell carcinoma of the pancreas. A case report
and review of the literature.Pancreatology.
2004;4(6):521-6.
Small cell
carcinoma (SCC) of the pancreas is a rare malignancy with an
extremely poor prognosis. We present the case of a 74-year-old man
with a 2-month history of upper abdominal discomfort who was
diagnosed with SCC of the pancreas tail, involvement of
peripancreatic and mesenteric lymph nodes and multiple liver
metastases (extended disease). A CT scan and a positive somatostatin
receptor scintigraphy showed no evidence of a primary lung tumour.
The diagnosis of a SCC was confirmed by biopsy. Local tumour control
could be achieved by gemcitabine once a week and a long-acting
somatostatin analogue once a month, but liver metastasis showed
progress. Thus, 5-fluorouracil on a weekly basis was started. The
patient died 8 months after diagnosis and had not been hospitalised
in the meantime.
Curative
resection of a small cell carcinoma of the pancreas: report of a
case of long survival without chemotherapy.
J Gastroenterol Hepatol. 2004 Sep;19(9):1087-91.
A 41-year-old
asymptomatic man was, by chance, diagnosed as having a mass in the
left upper quadrant of the abdomen by ultrasound. Computed
tomography and magnetic resonance imaging showed a slightly enhanced
heterogeneous mass, measuring about 5 cm in diameter, adjacent to
the pancreas tail and spleen. On abdominal angiography the tumor was
found to be fed by the splenic artery, and no encasement was
observed. At operation the tumor was connected to the pancreas tail
and attached to the spleen, and no metastasis was evident. As a
result of these observations, a curative resection was performed. On
histological examination the tumor cells had no ductal or
architectural organization and were continuous to the normal
pancreatic tissues. The cells were negative for Grimelius argylphile
and the periodic acid schiff stain. Immunohistochemistry indicated
that the tumor cells were positive for keratin and epithelial
membrane antigen, but negative for chromogranin A, vimentin,
alpha1-antitrypsin and alpha1-antichymotrypsin. The tumor was
diagnosed as a small cell carcinoma of the pancreas, which is a rare
disease. In previously reported cases curative resection of the
tumor had not been possible because of its rapid progression and
metastasis, and the prognosis is generally very poor. In our case,
however, curative resection of the tumor was done, and the patient
is healthy with no signs of recurrence for 56 months after the
operation and with no additional therapy.
Diagnostic features on images in primary small cell
carcinoma of the pancreas.
Am J Gastroenterol. 1997 Feb;92(2):319-22.
Small cell
carcinoma of the pancreas is a rare tumor with very poor prognosis,
but the tumor is successfully treated by chemotherapy. Therefore,
small cell carcinoma must be differentiated from other pancreatic
tumors on images. A 71-year-old man presented with digestive
symptoms. Multiple hypoechoic masses were detected on transabdominal
ultrasonography and lateral shadow and posterior echo enhancement on
endoscopic ultrasonography. The dynamic computed tomography scan
revealed that the tumor walls were hypervascular at an early phase,
and that the central portions were gradually stained at a late phase
with differences among the tumors; tumor stains were also found on
angiography. The distal site of the main pancreatic duct was
completely interrupted, as seen on endoscopic retrograde
pancreatography. The resected specimens were composed of
circumferential hard walls and internally necrotic, hemorrhagic
contents of different degrees and were microscopically diagnosed as
small cell carcinoma. The tumor has to be differentiated from
hypervascular pancreatic tumors, especially islet cell tumors.
Primary small cell carcinoma of the
pancreas.Pathology.1993;25(3):240-2.
A 59 yr old
male presented with abdominal pain and jaundice. CT scan showed a
tumor in the pancreas with secondaries in the liver, peri-pancreatic
lymph nodes, vertebral bone marrow and subcutaneous tissue of the
neck together with a cervical lymph node. The patient died after 2
wks and autopsy revealed complete replacement of the pancreas by
tumor. Careful dissection of both lungs failed to show any tumor. A
diagnosis of primary small cell carcinoma of the pancreas was made.
Review of the literature indicates that this type of carcinoma
accounts for about 1% of all pancreatic cancers and is commoner in
elderly males who have a history of cigarette smoking. There is
usually a rapid progression of disease and widespread dissemination,
especially if untreated. Some success has been obtained with
chemotherapy.
Small cell
undifferentiated carcinoma of the pancreas. Report of a patient with
tumor marker studies.Cancer.
1992;70(6):1514-9.
BACKGROUND.
Small cell undifferentiated carcinoma of the pancreas is a rare type
of pancreatic neoplasm. METHODS. The authors report the clinical and
pathologic aspects of a patient with this malignant lesion and an
extensive serologic and immunohistochemical survey of potential
ectopically produced hormones or tumor markers. RESULTS.
Neuron-specific enolase (NSE) emerged as a tumor marker.
CONCLUSIONS. NSE could be valuable in the diagnosis and management
of other patients with this rare disease.
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