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• W2920966125 abstract "Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGC) is a rare malignancy that comprises <1% of all exocrine pancreatic tumors. This tumor was initially described by Rosal et al (1968) and remain as a rare and aggressive form of all pancreatic cancers. UC-OGC is composed of 2 cell populations: a mononuclear cell population and osteoclastic tumor giant cells of uncertain lineage. The malignancy is seen as a large cystic neoplasm associated with hemorrhage and necrosis usually in the head and body of the pancreas. Patients present with symptoms of abdominal pain, a palpable mass, weight loss and jaundice. Here we present a case of UC-OGC of the pancreatic body. Patient is a 92-year-old Caucasian female with past medical history of cerebrovascular accident, carotid artery disease and atrial fibrillation who presented initially to her primary care physician with complaints of abdominal pain and generalized weakness. CT scan of the abdomen showed 3.7cm mass in the body of the pancreas. Patient has normal concentrations of CA 19-9 (19 U/ml) and CEA (2.5 mg/ml). Patient had endoscopic ultrasonography (EUS) three days later. EUS revealed 3.6cm x 2.8cm hypoechoic mass in the body of the pancreas. Multiple fine needle biopsies of the mass were performed. Initial microscopic pathologic findings revealed numerous spindle cells and multinucleated giant cells. Final pathology disclosed UC-OGC. Patient refused surgery and chemotherapy and opted for palliative care instead. Sekulic el al categorize UC-OGC as a rare subtype of ductal adenocarcinoma of the pancreas. UCOGC usually show immunohistochemical staining positivity for CD68 consistent with monocytic lineage, although the exact origin and pathophysiology remains unknown. They do share similar genetic derangements including activation of oncogene KRAS similar to pancreatic ductal adenocarcinoma however epithelial markers are frequently absent. Treatment mainstay remains surgical usually requiring pancreaticoduodenectomy with regional lymphadenectomy as these tumors have a high propensity for localized infiltration. Some isolated case reports have additionally reported chemotherapeutic response to the agent gemcitabine. However, there is no consensus on chemotherapeutic agents due to the low incidence of this variant. The prognosis of this variant is poor with median survival period of less than 1 year.1286_A.tif Figure 1: Histological slide showing osteoclast-like giant cells which were observed with hematoxylin and eosin staining (magnification × 20). Arrows show osteoclast-like giant cells." @default.
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• W2920966125 date "2018-10-01" @default.
• W2920966125 modified "2023-09-25" @default.
• W2920966125 title "Undifferentiated Carcinoma with Osteoclast-Like Giant Cells of Pancreas: A Case Report" @default.
• W2920966125 doi "https://doi.org/10.14309/00000434-201810001-01286" @default.
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