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A Case Report Presenting an Undifferentiated Pancreatic Carcinoma with Osteoclastic-Like Giant Cells with an Unusual Indolent Course

Patient: Male, 77 Final Diagnosis: Undifferentiated pancreatic carcinoma with osteoclastic giant cells like tumor Symptoms: Severe abdominal pain Medication: — Clinical Procedure: — Specialty: Surgery OBJECTIVE: Rare disease BACKGROUND: Undifferentiated pancreatic carcinoma with osteoclast-like gian...

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Autores principales: Nehmeh, William A., Trak-Smayra, Viviane, Tarhini, Ahmad, Gabriel, Michel Fouad, Sayegh, Raymond B., Noun, Roger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900831/
https://www.ncbi.nlm.nih.gov/pubmed/31767823
http://dx.doi.org/10.12659/AJCR.916810
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author Nehmeh, William A.
Trak-Smayra, Viviane
Tarhini, Ahmad
Gabriel, Michel Fouad
Sayegh, Raymond B.
Noun, Roger
author_facet Nehmeh, William A.
Trak-Smayra, Viviane
Tarhini, Ahmad
Gabriel, Michel Fouad
Sayegh, Raymond B.
Noun, Roger
author_sort Nehmeh, William A.
collection PubMed
description Patient: Male, 77 Final Diagnosis: Undifferentiated pancreatic carcinoma with osteoclastic giant cells like tumor Symptoms: Severe abdominal pain Medication: — Clinical Procedure: — Specialty: Surgery OBJECTIVE: Rare disease BACKGROUND: Undifferentiated pancreatic carcinoma with osteoclast-like giant cells represents less than 1% of pancreatic cancers. Histogenesis and prognosis are still debated. Three subtypes are defined by the World Health Organization: osteoclastic, pleomorphic, and mixed. The differential diagnosis of a pancreatic tumor with giant cells varies from a benign osteoclastoma to an undifferentiated pancreatic carcinoma with osteoclastic-like cells. The specimen should be carefully examined to rule out conventional pancreatic adenocarcinoma even in the presence of the giant cells. CASE REPORT: A 77-year-old male was diagnosed with a pancreatic tail tumor with osteoclastic like cells revealed by a biopsy done by echo-endoscopy; the patient was lost to follow up for 24 months before he was admitted to our institute for severe abdominal pain. A computed tomography showed the same lesion without progression. He was operated on using laparoscopic distal pancreatectomy with splenectomy. Pathology analysis revealed the presence of osteoclast-like giant cells without pleomorphic cells. Mutated KRAS on molecular study confirmed the diagnosis of undifferentiated pancreatic carcinoma with osteoclast-like giant cells. The patient was in good performance status and disease-free 19 months after surgery without any sign of progression. CONCLUSIONS: Undifferentiated pancreatic carcinoma with osteoclast-like cells has a challenging pathology diagnosis. Molecular and immunostaining are essential to diagnosis. The absence of pleomorphic cells in the present case has classified it into the osteoclastic subtype. Further cases and studies are needed to confirm the heterogeneity of the malignant course between subtypes.
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spelling pubmed-69008312019-12-16 A Case Report Presenting an Undifferentiated Pancreatic Carcinoma with Osteoclastic-Like Giant Cells with an Unusual Indolent Course Nehmeh, William A. Trak-Smayra, Viviane Tarhini, Ahmad Gabriel, Michel Fouad Sayegh, Raymond B. Noun, Roger Am J Case Rep Articles Patient: Male, 77 Final Diagnosis: Undifferentiated pancreatic carcinoma with osteoclastic giant cells like tumor Symptoms: Severe abdominal pain Medication: — Clinical Procedure: — Specialty: Surgery OBJECTIVE: Rare disease BACKGROUND: Undifferentiated pancreatic carcinoma with osteoclast-like giant cells represents less than 1% of pancreatic cancers. Histogenesis and prognosis are still debated. Three subtypes are defined by the World Health Organization: osteoclastic, pleomorphic, and mixed. The differential diagnosis of a pancreatic tumor with giant cells varies from a benign osteoclastoma to an undifferentiated pancreatic carcinoma with osteoclastic-like cells. The specimen should be carefully examined to rule out conventional pancreatic adenocarcinoma even in the presence of the giant cells. CASE REPORT: A 77-year-old male was diagnosed with a pancreatic tail tumor with osteoclastic like cells revealed by a biopsy done by echo-endoscopy; the patient was lost to follow up for 24 months before he was admitted to our institute for severe abdominal pain. A computed tomography showed the same lesion without progression. He was operated on using laparoscopic distal pancreatectomy with splenectomy. Pathology analysis revealed the presence of osteoclast-like giant cells without pleomorphic cells. Mutated KRAS on molecular study confirmed the diagnosis of undifferentiated pancreatic carcinoma with osteoclast-like giant cells. The patient was in good performance status and disease-free 19 months after surgery without any sign of progression. CONCLUSIONS: Undifferentiated pancreatic carcinoma with osteoclast-like cells has a challenging pathology diagnosis. Molecular and immunostaining are essential to diagnosis. The absence of pleomorphic cells in the present case has classified it into the osteoclastic subtype. Further cases and studies are needed to confirm the heterogeneity of the malignant course between subtypes. International Scientific Literature, Inc. 2019-11-26 /pmc/articles/PMC6900831/ /pubmed/31767823 http://dx.doi.org/10.12659/AJCR.916810 Text en © Am J Case Rep, 2019 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Nehmeh, William A.
Trak-Smayra, Viviane
Tarhini, Ahmad
Gabriel, Michel Fouad
Sayegh, Raymond B.
Noun, Roger
A Case Report Presenting an Undifferentiated Pancreatic Carcinoma with Osteoclastic-Like Giant Cells with an Unusual Indolent Course
title A Case Report Presenting an Undifferentiated Pancreatic Carcinoma with Osteoclastic-Like Giant Cells with an Unusual Indolent Course
title_full A Case Report Presenting an Undifferentiated Pancreatic Carcinoma with Osteoclastic-Like Giant Cells with an Unusual Indolent Course
title_fullStr A Case Report Presenting an Undifferentiated Pancreatic Carcinoma with Osteoclastic-Like Giant Cells with an Unusual Indolent Course
title_full_unstemmed A Case Report Presenting an Undifferentiated Pancreatic Carcinoma with Osteoclastic-Like Giant Cells with an Unusual Indolent Course
title_short A Case Report Presenting an Undifferentiated Pancreatic Carcinoma with Osteoclastic-Like Giant Cells with an Unusual Indolent Course
title_sort case report presenting an undifferentiated pancreatic carcinoma with osteoclastic-like giant cells with an unusual indolent course
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900831/
https://www.ncbi.nlm.nih.gov/pubmed/31767823
http://dx.doi.org/10.12659/AJCR.916810
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