Cephalic undifferentiated carcinoma with osteoclast-like giant cells arising from the main pancreatic duct: case report and literature review
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Published
Apr 13, 2019
Abstract
Undifferentiated carcinoma with osteoclast-like giant cell (UCOGC) is a ductal carcinoma variant with a recently reported more protracted survival and pathognomonic histology comprising two cell populations: the mononuclear tumoral cells and nontumoral multinucleated giant cells. It usually presents as a large heterogenic tumor with mixed solid-cystic components. The tumor develops from the ductal epithelium but the sequence of epithelial changes is often not identified due to the rapid tumoral growth and associated necrotic changes. We report a case of a 76-year-old patient diagnosed with cephalic UCOGC originating in the epithelium of the main pancreatic duct with endoluminal growth and foci of other ductal neoplasms (high-grade pancreatic intraepithelial neoplasia (PanIN) and conventional ductal carcinoma). The particularity of our case consists in the identification of the columnar epithelium conversion, through high-grade PanIN, into UCOGC specific malignant features, in a large size tumor – aspect usually reported in small tumors. Alongside our case we also present a brief literature review of cephalic UCOGC case reports and case series.
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Keywords
pancreatic UCOGC, ductal carcinoma, high-grade PanIN
References
1. Rosai J. Carcinoma of pancreas simulating giant cell tumor of bone. Electron-microscopic evidence of its acinar cell origin. Cancer 1968; 22(2):333-344.
2. Alguacil-Garcia A, Weiland LH. The histologic spectrum, prognosis, and histogenesis of the sarcomatoid carcinoma of the pancreas. Cancer 1977; 39(3):1181-1189.
3. Fujii K, Nitta T, Kawasaki H et al. Anaplastic carcinoma of the pancreas arising in an intraductal papillary mucinous neoplasm: A case report. Mol Clin Oncol 2016; 4(1):39-42.
4. Temesgen WM, Wachtel M, Dissanaike S. Osteoclastic giant cell tumor of the pancreas. Int J Surg Case Rep 2014; 5(4):175-179.
5. Georgiou GΚ, Balasi E, Siozopoulou V, Tsili A, Fatouros M, Glantzounis G. Undifferentiated carcinoma of the head of pancreas with osteoclast-like giant cells presenting as a symptomatic cystic mass, following acute pancreatitis: Case report and review of the literature. Int J Surg Case Rep 2016; 19:106-108.
6. Joo YE, Heo T, Park CH et al. A case of osteoclast-like giant cell tumor of the pancreas with ductal adenocarcinoma: histopathological, immunohistochemical, ultrastructural and molecular biological studies. J Korean Med Sci 2005; 20(3):516-520.
7. Zhang L, Lee JM, Yoon JH et al. Huge and recurrent undifferentiated carcinoma with osteoclast-like giant cells of the pancreas. Quant Imaging Med Surg 2018; 8(4):457-460.
8. Luchini C, Pea A, Lionheart G et al. Pancreatic undifferentiated carcinoma with osteoclast-like giant cells is genetically similar to, but clinically distinct from, conventional ductal adenocarcinoma. J Pathol 2017; 243(2):148-154.
9. Muraki T, Reid MD, Basturk O et al. Undifferentiated Carcinoma With Osteoclastic Giant Cells of the Pancreas: Clinicopathologic Analysis of 38 Cases Highlights a More Protracted Clinical Course Than Currently Appreciated. Am J Surg Pathol 2016; 40(9):1203-1216.
10. Gao HQ, Yang YM, Zhuang Y, Liu P. Locally advanced undifferentiated carcinoma with osteoclast-like giant cells of the pancreas. World J Gastroenterol 2015; 21(2):694-698.
11. Hur YH, Kim HH, Seoung JS et al. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. J Korean Surg Soc 2011; 81(2):146-150.
12. Jang KT, Park SM, Basturk O et al. Clinicopathologic characteristics of 29 invasive carcinomas arising in 178 pancreatic mucinous cystic neoplasms with ovarian-type stroma: implications for management and prognosis. Am J Surg Pathol 2015; 39(2):179-187.
13. Guo YL, Ruan LT, Wang QP, Lian J. Undifferentiated carcinoma with osteoclast-like giant cells of pancreas: A case report with review of the computed tomography findings. Medicine (Baltimore) 2018; 97(48):e13516.
14. Chiarelli M, Guttadauro A, Gerosa M et al. An indeterminate mucin-producing cystic neoplasm containing an undifferentiated carcinoma with osteoclast-like giant cells: a case report of a rare association of pancreatic tumors. BMC Gastroenterol 2015; 15:161.
15. Bergmann F, Esposito I, Michalski CW, Herpel E, Friess H, Schirmacher P. Early undifferentiated pancreatic carcinoma with osteoclastlike giant cells: direct evidence for ductal evolution. Am J Surg Pathol 2007; 31(12):1919-1925.
16. Fukushima N, Hruban RH, Kato Y et al. Ductal adenocarcinoma variants and mixed neoplasm of the pancreas. in Bosman FT, Carniero F, Hruban RH, Theise ND, editors. WHO classification of tumours of the digestive system. 4th ed. Lyon, IARC, 2010; 294-295.
17. Jo S. Huge undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. World J Gastroenterol 2014; 20(10):2725-2730.
18. Verbeke CS, Menon KV. Osteoclast-like giant cell tumour of the pancreas: an undifferentiated carcinoma of duct epithelial origin. Pancreatology 2006; 6(3):254.
19. Njoumi N, Elalami FH, Attolou G et al. Undifferentiated pancreatic carcinoma with osteoclast-like giant cells: a case report. J Gastrointest Cancer 2014; 45 (Suppl 1):96-98.
20. Sakhi R, Hamza A, Khurram MS, Ibrar W, Mazzara P. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells reported in an asymptomatic patient: a rare case and literature review. Autops Case Rep 2017; 7(4):51-57.
21. Sah SK, Li Y, Li Y. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells: a rare case report and review of the literature. Int J Clin Exp Pathol 2015; 8(9):11785-11791.
22. Okazaki M, Makino I, Kitagawa H et al. A case report of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct. World J Gastroenterol 2014; 20(3):852-856.
23. Fujimoto T, Inatomi O, Mizuno R et al. Anaplastic pancreatic cancer diagnosed with endoscopic ultrasound guided fine needle aspiration showing hypervascular tumor: A case report. Medicine (Baltimore) 2018; 97(49):e13473.
24. Tezuka K, Yamakawa M, Jingu A, Ikeda Y, Kimura W. An unusual case of undifferentiated carcinoma in situ with osteoclast-like giant cells of the pancreas. Pancreas 2006; 33(3):304-310.
25. Schlitter AM, Segler A, Steiger K et al. Molecular, morphological and survival analysis of 177 resected pancreatic ductal adenocarcinomas (PDACs): Identification of prognostic subtypes. Sci Rep 2017; 7:41064.
26. Reid MD, Muraki T, HooKim K et al. Cytologic features and clinical implications of undifferentiated carcinoma with osteoclastic giant cells of the pancreas: An analysis of 15 cases. Cancer Cytopathol 2017; 125(7):563-575.
27. Chen YC, Chen LA, Lin CH, Wang SN. Undifferentiated pancreatic carcinoma with osteoclast-like giant cells: A rare entity with potential misdiagnosis of a gastrointestinal stromal tumor on preoperative evaluation. Kaohsiung J Med Sci 2016; 32(11):593-594.
28. Kobayashi S, Nakano H, Ooike N, Oohashi M, Koizumi S, Otsubo T. Long-term survivor of a resected undifferentiated pancreatic carcinoma with osteoclast-like giant cells who underwent a second curative resection: A case report and review of the literature. Oncol Lett 2014; 8(4):1499-1504.
29. Saito H, Kashiyama H, Murohashi T, Sasaki K, Misawa R, Ohwada S. Case of Six-Year Disease-Free Survival with Undifferentiated Carcinoma of the Pancreas. Case Rep Gastroenterol 2016; 10(2):472-478.
30. Paniccia A, Torphy R, Devaraj K, Schulick RD. Anaplastic Pancreatic Carcinoma Arising Within a Mucinous Cystic Neoplasm of the Pancreas: A Case Report and a Brief Review of the Literature. J Pancreat Cancer 2017; 3(1):40-45.
31. Yoshioka M, Uchinami H, Watanabe G et al. Effective use of gemcitabine in the treatment of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas with portal vein tumor thrombus. Intern Med 2012; 51(16):2145-2150.
32. Matsuzawa G, Shirabe K, Gion T et al. Surgically resected undifferentiated carcinoma with osteoclast-like giant cells of the periampullary region involving the orifice of the papilla of Vater: Report of a case. Surg Today 2010; 40(4):376-379.
33. Maksymov V, Khalifa MA, Bussey A, Carter B, Hogan M. Undifferentiated (anaplastic) carcinoma of the pancreas with osteoclast-like giant cells showing various degree of pancreas duct involvement. A case report and literature review. JOP 2011; 12(2):170-176.
34. Mochizuki K, Kondo T, Oishi N et al. Immature squamous metaplasia (focal atypical epithelial hyperplasia) of the pancreatic duct-immunohistochemical distinction from intraductal carcinoma. Histopathology 2013; 63(3):343-350.
35. Pan ZG, Wang B. Anaplastic carcinoma of the pancreas associated with a mucinous cystic adenocarcinoma. A case report and review of the literature. JOP 2007; 8(6):775-782.
36. Basturk O, Hong SM, Wood LD et al. A Revised Classification System and Recommendations From the Baltimore Consensus Meeting for Neoplastic Precursor Lesions in the Pancreas. Am J Surg Pathol 2015; 39(12):1730-1741.
37. Brierley JD, Gospodarowicz MK, OSullivan B, Wittekind Ch. Introduction. in Brierley JD, Gospodarowicz MK, Wittekind Ch, editors. TNM classification of malignant tumours. 8th ed. Oxford, Hoboken, John Wiley & Sons, 2017, 27.
38. Yamaguchi J, Yokoyama Y, Kokuryo T, Ebata T, Nagino M. Cells of origin of pancreatic neoplasms. Surg Today 2018; 48(1):9-17.
39. Riva G, Pea A, Pilati C et al. Histo-molecular oncogenesis of pancreatic cancer: From precancerous lesions to invasive ductal adenocarcinoma. World J Gastrointest Oncol 2018; 10(10):317-327.
40. Seimiya T, Otsuka M, Iwata T et al. Inflammation and de-differentiation in pancreatic carcinogenesis. World J Clin Cases 2018; 6(15):882-891.
41. Mullick SS, Mody DR. "Osteoclastic" giant cell carcinoma of the pancreas. Report of a case with aspiration cytology. Acta Cytol 1996; 40(5):975-979.
42. Carvounis EE, Smyrniotis V, Chatziioannou A, Paphitis A. Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas. Int J Gastrointest Cancer 2003; 33(2-3):103-106.
43. Loya AC, Ratnakar KS, Shastry RA. Combined osteoclastic giant cell and pleomorphic giant cell tumor of the pancreas: a rarity. An immunohistochemical analysis and review of the literature. JOP 2004; 5(4):220-224.
44. Nai GA, Amico E, Gimenez VR, Guilmar M. Osteoclast-like giant cell tumor of the pancreas associated with mucus-secreting adenocarcinoma. Case report and discussion of the histogenesis. Pancreatology 2005; 5(2-3):279-284.
45. Koorstra JB, Maitra A, Morsink FH et al. Undifferentiated carcinoma with osteoclastic giant cells (UCOCGC) of the pancreas associated with the familial atypical multiple mole melanoma syndrome (FAMMM). Am J Surg Pathol 2008; 32(12):1905-1909.
46. Manduch M, Dexter DF, Jalink DW, Vanner SJ, Hurlbut DJ. Undifferentiated pancreatic carcinoma with osteoclast-like giant cells: report of a case with osteochondroid differentiation. Pathol Res Pract 2009; 205(5):353-359.
47. Mannan R, Khanna M, Bhasin TS, Misra V, Singh PA. Undifferentiated carcinoma with osteoclast-like giant cell tumor of the pancreas: a discussion of rare entity in comparison with pleomorphic giant cell tumor of the pancreas. Indian J Pathol Microbiol 2010; 53(4):867-868.
48. Oka K, Inoue K, Sugino S et al. Anaplastic carcinoma of the pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration: a case report and review of the literature. J Med Case Rep 2018; 12(1):152.
49. Yepuri N, Pruekprasert N, Ramani N et al. Osteoclast-like giant cell tumor of the pancreas-an unusual presentation in a patient with large mantle cell lymphoma. J Surg Case Rep 2018; 2018(12):rjy341.
50. Deckard-Janatpour K, Kragel S, Teplitz RL et al. Tumors of the pancreas with osteoclast-like and pleomorphic giant cells: an immunohistochemical and ploidy study. Arch Pathol Lab Med 1998; 122(3):266-272.
51. Hoorens A, Prenzel K, Lemoine NR, Klöppel G. Undifferentiated carcinoma of the pancreas: analysis of intermediate filament profile and Ki-ras mutations provides evidence of a ductal origin. J Pathol 1998; 185(1):53-60.
52. Molberg KH, Heffess C, Delgado R, Albores-Saavedra J. Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas and periampullary region. Cancer 1998; 82(7):1279-1287.
53. Chopra S, Wu ML, Imagawa DK, Lee J, Gu M. Endoscopic ultrasound-guided fine-needle aspiration of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a report of 2 cases with literature review. Diagn Cytopathol 2007; 35(9):601-606.
54. Layfield LJ, Bentz J. Giant-cell containing neoplasms of the pancreas: an aspiration cytology study. Diagn Cytopathol 2008; 36(4):238-244.
55. Naito Y, Kinoshita H, Okabe Y et al. Pathomorphologic study of undifferentiated carcinoma in seven cases: relationship between tumor and pancreatic duct epithelium. J Hepatobiliary Pancreat Surg 2009; 16(4):478-484.
56. Nojima T, Nakamura F, Ishikura M, Inoue K, Nagashima K, Kato H. Pleomorphic carcinoma of the pancreas with osteoclast-like giant cells. Int J Pancreatol 1993; 14(3):275-281.
57. Sakai Y, Kupelioglu AA, Yanagisawa A et al. Origin of giant cells in osteoclast-like giant cell tumors of the pancreas. Hum Pathol 2000; 31(10):1223-1229.
58. Fukukura Y, Kumagae Y, Hirahara M et al. CT and MRI features of undifferentiated carcinomas with osteoclast-like giant cells of the pancreas: a case series. Abdom Radiol (NY) 2019; doi: 10.1007/s00261-019-01958-9.
2. Alguacil-Garcia A, Weiland LH. The histologic spectrum, prognosis, and histogenesis of the sarcomatoid carcinoma of the pancreas. Cancer 1977; 39(3):1181-1189.
3. Fujii K, Nitta T, Kawasaki H et al. Anaplastic carcinoma of the pancreas arising in an intraductal papillary mucinous neoplasm: A case report. Mol Clin Oncol 2016; 4(1):39-42.
4. Temesgen WM, Wachtel M, Dissanaike S. Osteoclastic giant cell tumor of the pancreas. Int J Surg Case Rep 2014; 5(4):175-179.
5. Georgiou GΚ, Balasi E, Siozopoulou V, Tsili A, Fatouros M, Glantzounis G. Undifferentiated carcinoma of the head of pancreas with osteoclast-like giant cells presenting as a symptomatic cystic mass, following acute pancreatitis: Case report and review of the literature. Int J Surg Case Rep 2016; 19:106-108.
6. Joo YE, Heo T, Park CH et al. A case of osteoclast-like giant cell tumor of the pancreas with ductal adenocarcinoma: histopathological, immunohistochemical, ultrastructural and molecular biological studies. J Korean Med Sci 2005; 20(3):516-520.
7. Zhang L, Lee JM, Yoon JH et al. Huge and recurrent undifferentiated carcinoma with osteoclast-like giant cells of the pancreas. Quant Imaging Med Surg 2018; 8(4):457-460.
8. Luchini C, Pea A, Lionheart G et al. Pancreatic undifferentiated carcinoma with osteoclast-like giant cells is genetically similar to, but clinically distinct from, conventional ductal adenocarcinoma. J Pathol 2017; 243(2):148-154.
9. Muraki T, Reid MD, Basturk O et al. Undifferentiated Carcinoma With Osteoclastic Giant Cells of the Pancreas: Clinicopathologic Analysis of 38 Cases Highlights a More Protracted Clinical Course Than Currently Appreciated. Am J Surg Pathol 2016; 40(9):1203-1216.
10. Gao HQ, Yang YM, Zhuang Y, Liu P. Locally advanced undifferentiated carcinoma with osteoclast-like giant cells of the pancreas. World J Gastroenterol 2015; 21(2):694-698.
11. Hur YH, Kim HH, Seoung JS et al. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. J Korean Surg Soc 2011; 81(2):146-150.
12. Jang KT, Park SM, Basturk O et al. Clinicopathologic characteristics of 29 invasive carcinomas arising in 178 pancreatic mucinous cystic neoplasms with ovarian-type stroma: implications for management and prognosis. Am J Surg Pathol 2015; 39(2):179-187.
13. Guo YL, Ruan LT, Wang QP, Lian J. Undifferentiated carcinoma with osteoclast-like giant cells of pancreas: A case report with review of the computed tomography findings. Medicine (Baltimore) 2018; 97(48):e13516.
14. Chiarelli M, Guttadauro A, Gerosa M et al. An indeterminate mucin-producing cystic neoplasm containing an undifferentiated carcinoma with osteoclast-like giant cells: a case report of a rare association of pancreatic tumors. BMC Gastroenterol 2015; 15:161.
15. Bergmann F, Esposito I, Michalski CW, Herpel E, Friess H, Schirmacher P. Early undifferentiated pancreatic carcinoma with osteoclastlike giant cells: direct evidence for ductal evolution. Am J Surg Pathol 2007; 31(12):1919-1925.
16. Fukushima N, Hruban RH, Kato Y et al. Ductal adenocarcinoma variants and mixed neoplasm of the pancreas. in Bosman FT, Carniero F, Hruban RH, Theise ND, editors. WHO classification of tumours of the digestive system. 4th ed. Lyon, IARC, 2010; 294-295.
17. Jo S. Huge undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. World J Gastroenterol 2014; 20(10):2725-2730.
18. Verbeke CS, Menon KV. Osteoclast-like giant cell tumour of the pancreas: an undifferentiated carcinoma of duct epithelial origin. Pancreatology 2006; 6(3):254.
19. Njoumi N, Elalami FH, Attolou G et al. Undifferentiated pancreatic carcinoma with osteoclast-like giant cells: a case report. J Gastrointest Cancer 2014; 45 (Suppl 1):96-98.
20. Sakhi R, Hamza A, Khurram MS, Ibrar W, Mazzara P. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells reported in an asymptomatic patient: a rare case and literature review. Autops Case Rep 2017; 7(4):51-57.
21. Sah SK, Li Y, Li Y. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells: a rare case report and review of the literature. Int J Clin Exp Pathol 2015; 8(9):11785-11791.
22. Okazaki M, Makino I, Kitagawa H et al. A case report of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct. World J Gastroenterol 2014; 20(3):852-856.
23. Fujimoto T, Inatomi O, Mizuno R et al. Anaplastic pancreatic cancer diagnosed with endoscopic ultrasound guided fine needle aspiration showing hypervascular tumor: A case report. Medicine (Baltimore) 2018; 97(49):e13473.
24. Tezuka K, Yamakawa M, Jingu A, Ikeda Y, Kimura W. An unusual case of undifferentiated carcinoma in situ with osteoclast-like giant cells of the pancreas. Pancreas 2006; 33(3):304-310.
25. Schlitter AM, Segler A, Steiger K et al. Molecular, morphological and survival analysis of 177 resected pancreatic ductal adenocarcinomas (PDACs): Identification of prognostic subtypes. Sci Rep 2017; 7:41064.
26. Reid MD, Muraki T, HooKim K et al. Cytologic features and clinical implications of undifferentiated carcinoma with osteoclastic giant cells of the pancreas: An analysis of 15 cases. Cancer Cytopathol 2017; 125(7):563-575.
27. Chen YC, Chen LA, Lin CH, Wang SN. Undifferentiated pancreatic carcinoma with osteoclast-like giant cells: A rare entity with potential misdiagnosis of a gastrointestinal stromal tumor on preoperative evaluation. Kaohsiung J Med Sci 2016; 32(11):593-594.
28. Kobayashi S, Nakano H, Ooike N, Oohashi M, Koizumi S, Otsubo T. Long-term survivor of a resected undifferentiated pancreatic carcinoma with osteoclast-like giant cells who underwent a second curative resection: A case report and review of the literature. Oncol Lett 2014; 8(4):1499-1504.
29. Saito H, Kashiyama H, Murohashi T, Sasaki K, Misawa R, Ohwada S. Case of Six-Year Disease-Free Survival with Undifferentiated Carcinoma of the Pancreas. Case Rep Gastroenterol 2016; 10(2):472-478.
30. Paniccia A, Torphy R, Devaraj K, Schulick RD. Anaplastic Pancreatic Carcinoma Arising Within a Mucinous Cystic Neoplasm of the Pancreas: A Case Report and a Brief Review of the Literature. J Pancreat Cancer 2017; 3(1):40-45.
31. Yoshioka M, Uchinami H, Watanabe G et al. Effective use of gemcitabine in the treatment of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas with portal vein tumor thrombus. Intern Med 2012; 51(16):2145-2150.
32. Matsuzawa G, Shirabe K, Gion T et al. Surgically resected undifferentiated carcinoma with osteoclast-like giant cells of the periampullary region involving the orifice of the papilla of Vater: Report of a case. Surg Today 2010; 40(4):376-379.
33. Maksymov V, Khalifa MA, Bussey A, Carter B, Hogan M. Undifferentiated (anaplastic) carcinoma of the pancreas with osteoclast-like giant cells showing various degree of pancreas duct involvement. A case report and literature review. JOP 2011; 12(2):170-176.
34. Mochizuki K, Kondo T, Oishi N et al. Immature squamous metaplasia (focal atypical epithelial hyperplasia) of the pancreatic duct-immunohistochemical distinction from intraductal carcinoma. Histopathology 2013; 63(3):343-350.
35. Pan ZG, Wang B. Anaplastic carcinoma of the pancreas associated with a mucinous cystic adenocarcinoma. A case report and review of the literature. JOP 2007; 8(6):775-782.
36. Basturk O, Hong SM, Wood LD et al. A Revised Classification System and Recommendations From the Baltimore Consensus Meeting for Neoplastic Precursor Lesions in the Pancreas. Am J Surg Pathol 2015; 39(12):1730-1741.
37. Brierley JD, Gospodarowicz MK, OSullivan B, Wittekind Ch. Introduction. in Brierley JD, Gospodarowicz MK, Wittekind Ch, editors. TNM classification of malignant tumours. 8th ed. Oxford, Hoboken, John Wiley & Sons, 2017, 27.
38. Yamaguchi J, Yokoyama Y, Kokuryo T, Ebata T, Nagino M. Cells of origin of pancreatic neoplasms. Surg Today 2018; 48(1):9-17.
39. Riva G, Pea A, Pilati C et al. Histo-molecular oncogenesis of pancreatic cancer: From precancerous lesions to invasive ductal adenocarcinoma. World J Gastrointest Oncol 2018; 10(10):317-327.
40. Seimiya T, Otsuka M, Iwata T et al. Inflammation and de-differentiation in pancreatic carcinogenesis. World J Clin Cases 2018; 6(15):882-891.
41. Mullick SS, Mody DR. "Osteoclastic" giant cell carcinoma of the pancreas. Report of a case with aspiration cytology. Acta Cytol 1996; 40(5):975-979.
42. Carvounis EE, Smyrniotis V, Chatziioannou A, Paphitis A. Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas. Int J Gastrointest Cancer 2003; 33(2-3):103-106.
43. Loya AC, Ratnakar KS, Shastry RA. Combined osteoclastic giant cell and pleomorphic giant cell tumor of the pancreas: a rarity. An immunohistochemical analysis and review of the literature. JOP 2004; 5(4):220-224.
44. Nai GA, Amico E, Gimenez VR, Guilmar M. Osteoclast-like giant cell tumor of the pancreas associated with mucus-secreting adenocarcinoma. Case report and discussion of the histogenesis. Pancreatology 2005; 5(2-3):279-284.
45. Koorstra JB, Maitra A, Morsink FH et al. Undifferentiated carcinoma with osteoclastic giant cells (UCOCGC) of the pancreas associated with the familial atypical multiple mole melanoma syndrome (FAMMM). Am J Surg Pathol 2008; 32(12):1905-1909.
46. Manduch M, Dexter DF, Jalink DW, Vanner SJ, Hurlbut DJ. Undifferentiated pancreatic carcinoma with osteoclast-like giant cells: report of a case with osteochondroid differentiation. Pathol Res Pract 2009; 205(5):353-359.
47. Mannan R, Khanna M, Bhasin TS, Misra V, Singh PA. Undifferentiated carcinoma with osteoclast-like giant cell tumor of the pancreas: a discussion of rare entity in comparison with pleomorphic giant cell tumor of the pancreas. Indian J Pathol Microbiol 2010; 53(4):867-868.
48. Oka K, Inoue K, Sugino S et al. Anaplastic carcinoma of the pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration: a case report and review of the literature. J Med Case Rep 2018; 12(1):152.
49. Yepuri N, Pruekprasert N, Ramani N et al. Osteoclast-like giant cell tumor of the pancreas-an unusual presentation in a patient with large mantle cell lymphoma. J Surg Case Rep 2018; 2018(12):rjy341.
50. Deckard-Janatpour K, Kragel S, Teplitz RL et al. Tumors of the pancreas with osteoclast-like and pleomorphic giant cells: an immunohistochemical and ploidy study. Arch Pathol Lab Med 1998; 122(3):266-272.
51. Hoorens A, Prenzel K, Lemoine NR, Klöppel G. Undifferentiated carcinoma of the pancreas: analysis of intermediate filament profile and Ki-ras mutations provides evidence of a ductal origin. J Pathol 1998; 185(1):53-60.
52. Molberg KH, Heffess C, Delgado R, Albores-Saavedra J. Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas and periampullary region. Cancer 1998; 82(7):1279-1287.
53. Chopra S, Wu ML, Imagawa DK, Lee J, Gu M. Endoscopic ultrasound-guided fine-needle aspiration of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a report of 2 cases with literature review. Diagn Cytopathol 2007; 35(9):601-606.
54. Layfield LJ, Bentz J. Giant-cell containing neoplasms of the pancreas: an aspiration cytology study. Diagn Cytopathol 2008; 36(4):238-244.
55. Naito Y, Kinoshita H, Okabe Y et al. Pathomorphologic study of undifferentiated carcinoma in seven cases: relationship between tumor and pancreatic duct epithelium. J Hepatobiliary Pancreat Surg 2009; 16(4):478-484.
56. Nojima T, Nakamura F, Ishikura M, Inoue K, Nagashima K, Kato H. Pleomorphic carcinoma of the pancreas with osteoclast-like giant cells. Int J Pancreatol 1993; 14(3):275-281.
57. Sakai Y, Kupelioglu AA, Yanagisawa A et al. Origin of giant cells in osteoclast-like giant cell tumors of the pancreas. Hum Pathol 2000; 31(10):1223-1229.
58. Fukukura Y, Kumagae Y, Hirahara M et al. CT and MRI features of undifferentiated carcinomas with osteoclast-like giant cells of the pancreas: a case series. Abdom Radiol (NY) 2019; doi: 10.1007/s00261-019-01958-9.
How to Cite
Rusu, A., Giușcă, S. E., Ciobanu Apostol, D. G., Ionescu, L., & Caruntu, I. D. (2019). Cephalic undifferentiated carcinoma with osteoclast-like giant cells arising from the main pancreatic duct: case report and literature review. Archive of Clinical Cases, 6(1), Arch Clin Cases 2019; 6(1):6-21. https://doi.org/10.22551/2019.22.0601.10148
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How to Cite
Rusu, A., Giușcă, S. E., Ciobanu Apostol, D. G., Ionescu, L., & Caruntu, I. D. (2019). Cephalic undifferentiated carcinoma with osteoclast-like giant cells arising from the main pancreatic duct: case report and literature review. Archive of Clinical Cases, 6(1), Arch Clin Cases 2019; 6(1):6-21. https://doi.org/10.22551/2019.22.0601.10148