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Anaplastic carcinoma of the pancreas with squamous features: report of
a case and immunohistochemical study.Med
Sci Monit. 2005 Nov;11(11):CS65-8.
BACKGROUND:
Anaplastic carcinomas of the pancreas are rare aggressive tumors with
survival measurable in weeks. Many terms have been applied used to
describe these tumors, and anaplastic foci are identified in ductal
adenocarcinomas and in ectopic pancreata, but are not the dominant
pattern of growth. We herein present our experience with a case of
anaplastic carcinoma of the pancreas with squamous features in order
that allowed us to delineate the clinicopathologic and
immunohistochemical features of this rare entity. CASE REPORT:
According to imaging findings, the 77-year-old Japanese man was
diagnosed as the malignant pancreatic tumor, and underwent a surgical
resection. Histopathologically, anaplastic tumor cells showed focal
ductal and squamous features infiltrated into pancreatic parenchyma,
extrapancreatic fatty tissue, and stomach. The tumor cells showed
strong reactivity for cytokeratin, alpha-SMA, vimentin, NSE, and S-100
protein. Although immunoreactivity against p53 was negative, strong
positive immunostaining for proliferating cell nuclear antigen and
interleukin-1 receptor type I (IL-1RI) was observed in a the majority
of tumor cells, while the alpha6 integrin subunit was predominantly
strong expressed in the adenocarcinomatous lesion. The patient's
postoperative course was uneventful and he was treated with a
chemotherapy consisting of gemcitabine. After discharging from the
hospital, he had subsequently been observed as an outpatient and same
chemotherapy was followed by weekly. However, the patient suffered
from peritonitis carcinomatosa and re-increases of multiple liver
metastases, and he died in the fourteenth month after surgery.
CONCLUSIONS: Our immunohistochemical studies suggested that the
prognosis of the case with anaplastic carcinoma presented here would
be poor, due to the strong expression of integrins and IL-1RI.
Undifferentiated pancreatic carcinomas. Leap into chaos.Pathologe.
2005 Feb;26(1):18-21.
Undifferentiated pancreatic carcinomas are rare anaplastic variants of
ductal adenocarcinoma of the pancreas. They have to be distinguished
immunohistochemically from metastases of malignant melanoma or an
infiltrating sarcoma. An uncommon variant is undifferentiated
pancreatic carcinoma with osteoclast-like giant cells. This variant
can be associated with mucinous cystic neoplasms and is characterized
by abundant non-neoplastic osteoclast-like giant cells.
Anaplastic
pancreatic carcinoma. A case report and review of literature .
JOP. 2004 Nov 10;5(6):512-5.
CONTEXT:
Anaplastic pancreatic carcinoma is an aggressive neoplasm with
survival measurable in weeks. It presents as a large cystic mass with
loco-regional and distant spread. Three histological types have been
described: pleomorphic, spindle cell and sarcomatoid. CASE REPORT: We
describe the case of a 74-year-old woman with pleomorphic anaplastic
carcinoma of the pancreas diagnosed after laparoscopic biopsy. The
patient had a rapid downhill course with progression of the disease
and demise within 4 weeks after diagnostic laparoscopy. CONCLUSION:
Due to the rapid spread of the disease, no effective cure exists for
these tumors. A brief review of the histological and radiological
findings and the possible mechanisms of the pathogenesis of anaplastic
tumors is included in the discussion.
A
clinicopathologic and immunohistochemical study of 35 anaplastic
carcinomas of the pancreas with a review of the literature.
Ann Diagn Pathol. 2001 Jun;5(3):129-40.
Anaplastic
pancreatic carcinomas are rare tumors, frequently displaying a variety
of growth patterns. The literature lacks a comprehensive study of this
tumor. Thirty-five cases of anaplastic carcinoma of the pancreas
diagnosed between 1955 and 1997 were retrieved from the Endocrine
Registry at the Armed Forces Institute of Pathology. Histology,
immunophenotype, molecular analysis, and patient follow-up were
analyzed. The tumors of 10 women and 25 men, aged 34 to 85 years (mean
age at presentation, 62.5 years), were studied. Patients had vague
symptoms (weight loss, pain, and fatigue, nausea, or vomiting),
lasting an average of 13.2 weeks. The tumors, of an average size of
9.2 cm, were usually in the head or tail of the pancreas. The tumors
were widely infiltrative, histomorphologically separated into
predominantly large, pleomorphic cell, or spindle cell groups. Tumor
phagocytosis and necrosis were noted. Immunohistochemical studies
confirmed an epithelial origin with at least one epithelial marker in
78% of the tumors. K-ras mutations by sequence analysis were found in
eight of 12 cases tested. Surgical biopsy/excision was used in all
patients. Twenty-nine of 35 patients died of disease (average, 5.2
months), three died with no evidence of disease (average, 56.9
months), and three patients were alive at last follow-up (average,
94.0 months), one with residual disease. There was no statistically
significant difference in survival between patients with and without a
K-ras mutation. Anaplastic carcinoma of the pancreas usually occurs in
the head of the pancreas in older men. The epithelial nature of the
pleomorphic cells (giant or spindled) can usually be documented.
Patients with K-ras mutations have a shorter survival time, even
though the overall prognosis for all anaplastic carcinomas is fatal
(93% fatality; average survival, 448 days).
Phenotypical
characteristics of undifferentiated carcinoma of the pancreas: a
comparison with pancreatic ductal adenocarcinoma and relevance of E-cadherin,
alpha catenin and beta catenin expression.Oncol
Rep. 2001 Jul-Aug;8(4):745-52.
The
characteristics of undifferentiated (anaplastic) carcinoma (UC) of the
pancreas were analysed and compared with those of poorly
differentiated adenocarcinoma (PA). Eight cases of UC of the pancreas
were evaluated by clinicopathological and immunohistochemical methods
and compared with 20 cases of PA. Large size of the tumor, local
invasion and lymph node metastasis were frequently seen in UC, leading
to a significantly worse prognosis compared to that of PA (p=0.022).
Immunohistochemically, E-cadherin expression was completely lost in
7/8 UC cases, whereas half the PA cases revealed a strong reactivity
for E-cadherin. alpha- and beta-catenin expressions tended to be
impaired in UC compared with PA. The results suggest that the altered
expression of adhesion molecules is correlated with dedifferentiated
change and is contributory to its aggressive biological behaviour.
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