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Case Reports
. 2014 Jan 21;20(3):852-6.
doi: 10.3748/wjg.v20.i3.852.

A case report of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct

Mitsuyoshi Okazaki  1 , Isamu Makino  1 , Hirohisa Kitagawa  1 , Shinichi Nakanuma  1 , Hironori Hayashi  1 , Hisatoshi Nakagawara  1 , Tomoharu Miyashita  1 , Hidehiro Tajima  1 , Hiroyuki Takamura  1 , Tetsuo Ohta  1
Affiliations
Case Reports

A case report of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct

Mitsuyoshi Okazaki et al. World J Gastroenterol. .

Abstract

We herein report a case of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct. A 76-year-old male was referred to our hospital for treatment of a pancreatic tumor. Preoperative examinations revealed a poorly defined tumor in the main pancreatic duct in the body of the pancreas, accompanied with severe dilatation of the main pancreatic duct, which was diagnosed as an intraductal papillary-mucinous neoplasm. We performed distal pancreatectomy and splenectomy. The pathological examination revealed that the tumor consisted of a mixture of anaplastic carcinoma (giant cell type) and adenocarcinoma in the pancreas. There was a papillary projecting tumor composed of anaplastic carcinoma in the dilated main pancreatic duct. The patient is now receiving chemotherapy because liver metastasis was detected 12 mo after surgery. In this case, we could observe a remarkable intraductal tumor growth into the main pancreatic duct. We also discuss the pathogenesis and characteristics of this rare tumor with specific tumor growth.

Keywords: Anaplastic carcinoma; Giant cell carcinoma; Intraductal tumor growth; Papillary projecting tumor.

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Figures

Figure 1
Figure 1
Abdominal computed tomography. A: An axial section image of an abdominal computed tomography showed dilatation of the main pancreatic duct (arrow head) and the adjacent solid tumor (arrow); B: The coronal section image revealed a cystic lesion measuring 6.0 cm × 3.5 cm in the body and tail of the pancreas (arrow).
Figure 2
Figure 2
Magnetic resonance cholangiopancreatography revealed a segmental defect of the main pancreatic duct by the solid tumor (arrow head) associated with the multilocular cystic lesion (arrow) in the body and tail of the pancreas.
Figure 3
Figure 3
Endoscopic retrograde cholangiopancreatography showed the dilatation of the main pancreatic duct. A: A filling defect in the main pancreatic duct (MPD) (arrow head); B: Intraductal ultrasonography demonstrated a filling lesion in the MPD (arrow).
Figure 4
Figure 4
Pathological findings. A: The dilated main pancreatic duct was filled with a papillary projecting tumor; B: The main tumor was dark reddish-brown (arrow head) and white (arrow) on the surface, and showed significant dilatation of the main pancreatic duct (dotted line region).
Figure 5
Figure 5
Microscopic appearance of the tumor. Hematoxylin and eosin staining showed adenocarcinoma (tub1, tub2) in the white component, bizarre mono-and multi-nucleated giant cells in the dark reddish-brown component and a projecting tumor into the main pancreatic duct. A: the white component; B: the dark red-brown component; C: the projecting tumor.
See this image and copyright information in PMC

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