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Lu L, Wang L, Peng C, Chen L, He X, Shao C, Wang C, Ge R. Undifferentiated carcinoma of the liver with osteoclast-like giant cells: a case report and literature review. Infect Agent Cancer 2024; 19:14. [PMID: 38643211 PMCID: PMC11032592 DOI: 10.1186/s13027-024-00582-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. Osteoclast-like giant cells (OGCs) are relatively more common in pancreatic cancer, but extremely rare in HCC. Currently, there have been only a few reported cases of OGCs in HCC, and their presence indicates an aggressive clinical course. Here, we present a case of primary undifferentiated carcinoma of the liver with OGCs in a 49-year-old male patient, and through a literature review, we summarize 20 similar cases to further understand the diagnosis, treatment, and clinical course of this disease entity.
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Affiliation(s)
- Lixia Lu
- Department of Histopathology, Ningbo Clinical Pathology Diagnosis Center, No. 685 East of North Huangcheng Road, Jiangbei District, Ningbo City, 315021, Zhejiang Province, China
| | - Li Wang
- Department of Histopathology, Ningbo Clinical Pathology Diagnosis Center, No. 685 East of North Huangcheng Road, Jiangbei District, Ningbo City, 315021, Zhejiang Province, China
| | - Can Peng
- Department of Histopathology, Ningbo Clinical Pathology Diagnosis Center, No. 685 East of North Huangcheng Road, Jiangbei District, Ningbo City, 315021, Zhejiang Province, China
| | - Li Chen
- Department of Histopathology, Ningbo Clinical Pathology Diagnosis Center, No. 685 East of North Huangcheng Road, Jiangbei District, Ningbo City, 315021, Zhejiang Province, China
| | - Ximan He
- Department of Histopathology, Ningbo Clinical Pathology Diagnosis Center, No. 685 East of North Huangcheng Road, Jiangbei District, Ningbo City, 315021, Zhejiang Province, China
| | - Chenning Shao
- Department of Histopathology, Ningbo Clinical Pathology Diagnosis Center, No. 685 East of North Huangcheng Road, Jiangbei District, Ningbo City, 315021, Zhejiang Province, China
| | - Chunnian Wang
- Department of Histopathology, Ningbo Clinical Pathology Diagnosis Center, No. 685 East of North Huangcheng Road, Jiangbei District, Ningbo City, 315021, Zhejiang Province, China
| | - Rong Ge
- Department of Histopathology, Ningbo Clinical Pathology Diagnosis Center, No. 685 East of North Huangcheng Road, Jiangbei District, Ningbo City, 315021, Zhejiang Province, China.
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Li Y, Han F. A rare case of undifferentiated carcinoma of the pancreas with osteoblastic giant cells. Asian J Surg 2023; 46:4968-4969. [PMID: 37661480 DOI: 10.1016/j.asjsur.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/07/2023] [Indexed: 09/05/2023] Open
Affiliation(s)
- Yanxi Li
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiangyang District, Luzhou, 64600, PR China
| | - Fugang Han
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiangyang District, Luzhou, 64600, PR China.
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3
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Gielen AHC, Samarska I, Den Dulk M, Beckervordersandforth J, Dejong KHC, Bouwense SAW, Dewulf M. Osteoclast-like giant cells in hepatocellular carcinoma case description and review of the literature. Acta Chir Belg 2023; 123:178-184. [PMID: 34110978 DOI: 10.1080/00015458.2021.1940443] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The presence of osteoclast-like giant cells (OGC) in hepatocellular carcinoma (HCC) is rare and literature on this topic is scarce. In this article, we report on a case of a 77-year-old male patient with HCC with OGC and provide an overview of the current literature. METHODS We conducted a systematic search to find all available literature on OGC in HCC. The electronic databases PubMed, Web of Science, Embase and CENTRAL were searched from inception until October 2020. RESULTS Thirteen articles on this topic were identified and were included in this review. Data on 14 patients were available, described in twelve case reports, one patient in a patient series and the present case. Median age of included patients was 68 years. Two patients underwent neoadjuvant therapy prior to surgery. Of the 14 cases, eight tumours with OGC arose in a cirrhotic liver. Oncological outcome in this series was unfavourable, even after surgical resection, with a median disease-free survival of 75 d. CONCLUSIONS The presence of OGC in HCC is rare. Current literature is scarce, and suggests an unfavourable outcome in regard to overall survival of HCC.
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Affiliation(s)
- Anke H C Gielen
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Iryna Samarska
- Department of Pathology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marcel Den Dulk
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Kees H C Dejong
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Surgery, Universitätsklinikum Aachen, Aachen, Germany
| | - Stefan A W Bouwense
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Maxime Dewulf
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Surgery, AZ Maria Middelares, Gent, Belgium
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Pop RM, Diaconu CI, Rimbaş M, Mateescu RB, Rouhani F, Popp C, Manfrin E, Crinò SF, Cauni V. EUS-guided fine needle biopsy is able to provide diagnosis in rare osteoclast-like giant cells undifferentiated carcinoma of the pancreas: Report of two cases. Rom J Intern Med 2023. [PMID: 36884386 DOI: 10.2478/rjim-2023-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Indexed: 03/09/2023]
Abstract
Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UC-OGC) is a rare subtype of pancreatic cancer, accounting for less than 1% of all pancreatic tumors. Preoperative diagnosis is cumbersome as cross-sectional imaging is often not capable to distinguish between UCOGC and other pancreatic tumors such as pancreatic adenocarcinoma, mucinous carcinoma or neuroendocrine tumors and specific tumor markers seem to be lacking. Endoscopic ultrasound r `m(EUS) with tissue acquisition via fine-needle aspiration (FNA) or biopsy (FNB) with microscopic HE staining and immunohistochemistry allows for an accurate diagnosis, thus influencing further treatment. We present herein the cases of two patients with osteoclast-like giant cells tumors of the pancreas diagnosed by EUS-guided fine needle biopsy and perform a literature review on the role of EUS-guided biopsy for diagnosis.
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Deng Y, Wang Y, Zhang Y, Yang N, Ji X, Wu B. Undifferentiated hepatic carcinoma with osteoclast-like giant cells: A case report and literature review. Front Oncol 2023; 12:1018617. [PMID: 36698409 PMCID: PMC9868471 DOI: 10.3389/fonc.2022.1018617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Osteoclast-like giant cell tumor (OGCT) is a common bone tumor, occasionally observed in some extraosseous organs, but rarely involving the digestive system, especially the liver. Previously reported osteoclast-like giant cell carcinoma of the liver often coexists with sarcomatoid or hepatocellular carcinoma. Undifferentiated liver tumors with osteoclast-like giant cells (OGCs) are extremely rare. Due to its rarity, there is no consensus for diagnosis and treatment of undifferentiated liver tumors with OGCs. Definitive diagnosis comes from surgery, so there is often a long delay in diagnosis following the occurrence of symptoms. This case describes an extremely rare case of an undifferentiated liver tumor with OGCs in detail. It also summarizes the previously published cases based on liver tumors with OGCs from August 1980 to June 2021, providing extensive evidence to improve preoperative diagnosis and management options.
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Affiliation(s)
- Yujiao Deng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ya Wang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Zhang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Na Yang
- Department of Radiology, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Xingli Ji
- Department of Pathology, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Bing Wu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Bing Wu,
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Çağlayan D, Karakurt Eryilmaz M, Korkmaz M, Karaağaç M, Hendem E, Artaç M. Is pancreatic giant cell tumor resistant to standard chemotherapy? Anticancer Drugs 2022; 33:758-60. [PMID: 35946539 DOI: 10.1097/CAD.0000000000001331] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Pancreatic giant cell tumors (PGCTs), undifferentiated pancreatic carcinoma are rare tumors of the pancreas. PGCTs consist of osteoclastic, pleomorphic and mixed variants. PGCT is usually diagnosed at an advanced stage. PGCT has a worse prognosis than pancreatic ductal adenocarcinoma. Although surgery can be curative, there is no standard treatment approach for advanced PGCT. We present a case of PGCT that is resistant to standard therapy and progresses in a short time.
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Sajjadi E, Gaudioso G, Terrasi A, Boggio F, Venetis K, Ivanova M, Bertolasi L, Lopez G, Runza L, Premoli A, Lorenzini D, Guerini-Rocco E, Ferrero S, Vaira V, Fusco N. Osteoclast-like stromal giant cells in breast cancer likely belong to the spectrum of immunosuppressive tumor-associated macrophages. Front Mol Biosci 2022; 9:894247. [PMID: 36090031 PMCID: PMC9462457 DOI: 10.3389/fmolb.2022.894247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/28/2022] [Indexed: 12/11/2022] Open
Abstract
Background: Breast cancer with osteoclast-like stromal giant cells (OSGC) is an exceedingly rare morphological pattern of invasive breast carcinoma. The tumor immune microenvironment (TIME) of these tumors is populated by OSGC, which resemble osteoclasts and show a histiocytic-like immunophenotype. Their role in breast cancer is unknown. The osteoclast maturation in the bone is regulated by the expression of cytokines that are also present in the TIME of tumors and in breast cancer tumor-associated macrophages (TAMs). TAMs-mediated anti-tumor immune pathways are regulated by miRNAs akin to osteoclast homeostasis. Here, we sought to characterize the different cellular compartments of breast cancers with OSGC and investigate the similarities of OSGC with tumor and TIME in terms of morphology, protein, and miRNA expression, specifically emphasizing on monocytic signatures. Methods and Results: Six breast cancers with OSGC were included. Tumor-infiltrating lymphocytes (TILs) and TAMs were separately quantified. The different cellular populations (i.e., normal epithelium, cancer cells, and OSGC) were isolated from tissue sections by laser-assisted microdissection. After RNA purification, 752 miRNAs were analyzed using a TaqMan Advanced miRNA Low-Density Array for all samples. Differentially expressed miRNAs were identified by computing the fold change (log2Ratio) using the Kolmogorov-Smirnov test and p values were corrected for multiple comparisons using the false discovery rate (FDR) approach. As a similarity analysis among samples, we used the Pearson test. The association between pairs of variables was investigated using Fisher exact test. Classical and non-classical monocyte miRNA signatures were finally applied. All OSGC displayed CD68 expression, TILs (range, 45–85%) and high TAMs (range, 35–75%). Regarding the global miRNAs profile, OSGC was more similar to cancer cells than to non-neoplastic ones. Shared deregulation of miR-143-3p, miR-195-5p, miR-181a-5p, and miR-181b-5p was observed between OSGC and cancer cells. The monocyte-associated miR-29a-3p and miR-21-3p were dysregulated in OSGCs compared with non-neoplastic or breast cancer tissues. Conclusion: Breast cancers with OSGC have an activated TIME. Shared epigenetic events occur during the ontogenesis of breast cancer cells and OSGC but the innumophenotype and miRNA profiles of the different cellular compartmens suggest that OSGC likely belong to the spectrum of M2 TAMs.
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Affiliation(s)
- Elham Sajjadi
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Gaudioso
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Terrasi
- Division of Molecular Biology, Biomedical Center, Faculty of Medicine, LMU Munich, Planegg-Martinsried, Munich, Germany
| | - Francesca Boggio
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Konstantinos Venetis
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Mariia Ivanova
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Letizia Bertolasi
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Lopez
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Letterio Runza
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Premoli
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniele Lorenzini
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Elena Guerini-Rocco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefano Ferrero
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Valentina Vaira
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Nicola Fusco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- *Correspondence: Nicola Fusco,
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Zhan K, Zhang S, Hu P, Chen J, Liu W, Niu Z. Undifferentiated carcinoma of the pancreas with osteoclast like giant cells: Literature review with CT/MR imaging findings in 3 cases. Radiol Case Rep 2022; 17:2529-2533. [PMID: 35601386 PMCID: PMC9118480 DOI: 10.1016/j.radcr.2022.03.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 11/19/2022] Open
Abstract
Undifferentiated carcinoma with osteoclast-like giant cells of pancreas (UCOGCP) is a relatively rare tumor worldwide. Its accurate preoperative diagnosis is extremely difficult. Because the mass is usually large and closely related to neighboring structures, it is difficult to locate the tumor and it is often misdiagnosed as pancreatic cancer, neuroendocrine tumor or gastrointestinal stromal tumor. Combining literature to analyze UCOGCP clinical features (including age of onset, prevalent location) and imaging features (including lesion size, mass nature), to explore the value of preoperative CT and MRI in the diagnosis and differential diagnosis of UCOGCP and hope to help clinical diagnosis and treatment.
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Affiliation(s)
- Kun Zhan
- Department of Radiology, Sir Run Run Shaw hospital, Zhejiang University School of Medicine, Hangzhou City 310016, Zhejiang Province, China
| | - Shizheng Zhang
- Department of Radiology, Sir Run Run Shaw hospital, Zhejiang University School of Medicine, Hangzhou City 310016, Zhejiang Province, China
| | - Peng Hu
- Department of Radiology, Sir Run Run Shaw hospital, Zhejiang University School of Medicine, Hangzhou City 310016, Zhejiang Province, China
| | - Jiao Chen
- Department of Radiology, Sir Run Run Shaw hospital, Zhejiang University School of Medicine, Hangzhou City 310016, Zhejiang Province, China
| | - Wangwang Liu
- Department of Pathology, Sir Run Run Shaw hospital, Zhejiang University School of Medicine, Hangzhou City 310016, Zhejiang Province, China
| | - Zhongfeng Niu
- Department of Radiology, Sir Run Run Shaw hospital, Zhejiang University School of Medicine, Hangzhou City 310016, Zhejiang Province, China
- Corresponding author.
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9
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Cao Y. Neural is Fundamental: Neural Stemness as the Ground State of Cell Tumorigenicity and Differentiation Potential. Stem Cell Rev Rep 2021. [PMID: 34714532 DOI: 10.1007/s12015-021-10275-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2021] [Indexed: 01/07/2023]
Abstract
Tumorigenic cells are similar to neural stem cells or embryonic neural cells in regulatory networks, tumorigenicity and pluripotent differentiation potential. By integrating the evidence from developmental biology, tumor biology and evolution, I will make a detailed discussion on the observations and propose that neural stemness underlies two coupled cell properties, tumorigenicity and pluripotent differentiation potential. Neural stemness property of tumorigenic cells can hopefully integrate different observations/concepts underlying tumorigenesis. Neural stem cells and tumorigenic cells share regulatory networks; both exhibit neural stemness, tumorigenicity and pluripotent differentiation potential; both depend on expression or activation of ancestral genes; both rely primarily on aerobic glycolytic metabolism; both can differentiate into various cells/tissues that are derived from three germ layers, leading to tumor formation resembling severely disorganized or more degenerated process of embryonic tissue differentiation; both are enriched in long genes with more splice variants that provide more plastic scaffolds for cell differentiation, etc. Neural regulatory networks, which include higher levels of basic machineries of cell physiological functions and developmental programs, work concertedly to define a basic state with fast cell cycle and proliferation. This is predestined by the evolutionary advantage of neural state, the ground or initial state for multicellularity with adaptation to an ancient environment. Tumorigenesis might represent a process of restoration of neural ground state, thereby restoring a state with fast proliferation and pluripotent differentiation potential in somatic cells. Tumorigenesis and pluripotent differentiation potential might be better understood from understanding neural stemness, and cancer therapy should benefit more from targeting neural stemness.
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Balakrishnan M, Pathan SK, Mallik MK, Hussein SAB, Al Shatti R, Kapila K. Fine-needle aspiration cytology of osteoclast-like giant cell tumor of liver-a case report with review of literature. Diagn Cytopathol 2021; 50:E18-E22. [PMID: 34499427 DOI: 10.1002/dc.24869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 08/11/2021] [Accepted: 08/30/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Meera Balakrishnan
- Department of Cytopathology, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Shahed Khan Pathan
- Department of Cytopathology, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | | | - Sundus A B Hussein
- Department of Histopathology, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Rashed Al Shatti
- Department of Surgery, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Kusum Kapila
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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Kharkhach A, Bouhout T, Serji B, El Harroudi T. Undifferentiated Pancreatic Carcinoma with Osteoclast-like Giant Cells: a Review and Case Report Analysis. J Gastrointest Cancer 2021; 52:1106-1113. [PMID: 33447945 DOI: 10.1007/s12029-021-00583-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 01/13/2023]
Affiliation(s)
- Ayoub Kharkhach
- Department of Surgical Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco.
| | - Tarik Bouhout
- Department of Surgical Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Badr Serji
- Department of Surgical Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Tijani El Harroudi
- Department of Surgical Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
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Ueberroth BE, Liu AJ, Graham RP, Bekaii-Saab TS, McWilliams RR, Mahipal A, Truty MJ, Mody K, Sonbol MB, Halfdanarson TR. Osteoclast-Like Giant Cell Tumors of the Pancreas: Clinical Characteristics, Genetic Testing, and Treatment Modalities. Pancreas 2021; 50:952-956. [PMID: 34369897 DOI: 10.1097/mpa.0000000000001858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES This study sought to better characterize patient characteristics, treatment options, and outcomes for osteoclast-like giant cell carcinoma of the pancreas, a rare subtype of pancreatic adenocarcinoma. METHODS This is a retrospective study of all patients with osteoclast-like giant cell carcinoma of pancreatic origin treated at Mayo Clinic from 2000 to present. Baseline patient characteristics, treatment modalities utilized, and outcomes were compiled. Overall survival (OS) and progression-free survival were assessed using Kaplan-Meier analysis with a significance level of P ≤ 0.05. RESULTS Fifteen patients met criteria for inclusion. Four patients had distant metastases at diagnosis, the remaining 11 with locoregional disease. Median OS for the entire cohort was 11 months. Metastatic disease was associated with significantly shorter OS (3.5 vs 14.1 months; P = 0.005). Three patients had no evidence of disease at time of analysis; all 3 were treated with complete resection followed by adjuvant chemotherapy. CONCLUSIONS Osteoclast-like giant cell carcinoma of the pancreas is an aggressive malignancy with poor prognosis. For patients with locoregional disease, surgical resection followed by adjuvant chemoradiation may play a role in extended disease-free survival. Metastatic disease presents a challenging entity to treat with little data to support any effective chemotherapy regimens.
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Affiliation(s)
| | - Alex J Liu
- From the Department of Internal Medicine, Mayo Clinic, Phoenix, AZ
| | | | | | | | - Amit Mahipal
- Department of Oncology, Mayo Clinic, Rochester, MN
| | - Mark J Truty
- Department of Surgery, Mayo Clinic, Rochester, MN
| | - Kabir Mody
- Department of Oncology, Mayo Clinic, Jacksonville, FL
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Abstract
Background Previous studies demonstrated the dependence of cancer on nerve. Recently, a growing number of studies reveal that cancer cells share the property and regulatory network with neural stem/progenitor cells. However, relationship between the property of neural stemness and cell tumorigenicity is unknown. Results We show that neural stem/progenitor cells, but not non-neural embryonic or somatic stem/progenitor cell types, exhibit tumorigenicity and the potential for differentiation into tissue types of all germ layers when they are placed in non-native environment by transplantation into immunodeficient nude mice. Likewise, cancer cells capable of tumor initiation have the property of neural stemness because of their abilities in neurosphere formation in neural stem cell-specific serum-free medium and in differentiation potential, in addition to their neuronal differentiation potential that was characterized previously. Moreover, loss of a pro-differentiation factor in myoblasts, which have no tumorigenicity, lead to the loss of myoblast identity, and gain of the property of neural stemness, tumorigenicity and potential for re-differentiation. By contrast, loss of neural stemness via differentiation results in the loss of tumorigenicity. These suggest that the property of neural stemness contributes to cell tumorigenicity, and tumor phenotypic heterogeneity might be an effect of differentiation potential of neural stemness. Bioinformatic analysis reveals that neural genes in general are correlated with embryonic development and cancer, in addition to their role in neural development; whereas non-neural genes are not. Most of neural specific genes emerged in typical species representing transition from unicellularity to multicellularity during evolution. Genes in Monosiga brevicollis, a unicellular species that is a closest known relative of metazoans, are biased toward neural cells. Conclusions We suggest that the property of neural stemness is the source of cell tumorigenicity. This is due to that neural biased unicellular state is the ground state for multicellularity and hence cell type diversification or differentiation during evolution, and tumorigenesis is a process of restoration of neural ground state in somatic cells along a default route that is pre-determined by an evolutionary advantage of neural state.
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Affiliation(s)
- Liyang Xu
- MOE Key Laboratory of Model Animals for Disease Study, and Model Animal Research Center of the Medical School, Nanjing University, 12 Xuefu Road, Pukou High-Tech Zone, Nanjing, 210061, China
| | - Min Zhang
- MOE Key Laboratory of Model Animals for Disease Study, and Model Animal Research Center of the Medical School, Nanjing University, 12 Xuefu Road, Pukou High-Tech Zone, Nanjing, 210061, China
| | - Lihua Shi
- MOE Key Laboratory of Model Animals for Disease Study, and Model Animal Research Center of the Medical School, Nanjing University, 12 Xuefu Road, Pukou High-Tech Zone, Nanjing, 210061, China
| | - Xiaoli Yang
- MOE Key Laboratory of Model Animals for Disease Study, and Model Animal Research Center of the Medical School, Nanjing University, 12 Xuefu Road, Pukou High-Tech Zone, Nanjing, 210061, China
| | - Lu Chen
- MOE Key Laboratory of Model Animals for Disease Study, and Model Animal Research Center of the Medical School, Nanjing University, 12 Xuefu Road, Pukou High-Tech Zone, Nanjing, 210061, China
| | - Ning Cao
- MOE Key Laboratory of Model Animals for Disease Study, and Model Animal Research Center of the Medical School, Nanjing University, 12 Xuefu Road, Pukou High-Tech Zone, Nanjing, 210061, China
| | - Anhua Lei
- MOE Key Laboratory of Model Animals for Disease Study, and Model Animal Research Center of the Medical School, Nanjing University, 12 Xuefu Road, Pukou High-Tech Zone, Nanjing, 210061, China
| | - Ying Cao
- MOE Key Laboratory of Model Animals for Disease Study, and Model Animal Research Center of the Medical School, Nanjing University, 12 Xuefu Road, Pukou High-Tech Zone, Nanjing, 210061, China.
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Moein S, Adibi R, da Silva Meirelles L, Nardi NB, Gheisari Y. Cancer regeneration: Polyploid cells are the key drivers of tumor progression. Biochim Biophys Acta Rev Cancer. 2020;1874:188408. [PMID: 32827584 DOI: 10.1016/j.bbcan.2020.188408] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/16/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022]
Abstract
In spite of significant advancements of therapies for initial eradication of cancers, tumor relapse remains a major challenge. It is for a long time known that polyploid malignant cells are a main source of resistance against chemotherapy and irradiation. However, therapeutic approaches targeting these cells have not been appropriately pursued which could partly be due to the shortage of knowledge on the molecular biology of cell polyploidy. On the other hand, there is a rising trend to appreciate polyploid/ multinucleated cells as key players in tissue regeneration. In this review, we suggest an analogy between the functions of polyploid cells in normal and malignant tissues and discuss the idea that cell polyploidy is an evolutionary conserved source of tissue regeneration also exploited by cancers as a survival factor. In addition, polyploid cells are highlighted as a promising therapeutic target to overcome drug resistance and relapse.
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Speisky D, Villarroel M, Vigovich F, Iotti A, García TA, Quero LB, Bregante M, de Dávila MTG. Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas diagnosed by endoscopic ultrasound guided biopsy. Ecancermedicalscience 2020; 14:1072. [PMID: 32863866 PMCID: PMC7434513 DOI: 10.3332/ecancer.2020.1072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Indexed: 12/23/2022] Open
Abstract
Undifferentiated pancreatic carcinoma with osteoclast-like giant cells is a rare tumour that has been published under a wide variety of names, including pleomorphic carcinoma, giant cell carcinoma, sarcomatoid carcinoma and carcinosarcoma, among others. For these reasons and its low frequency, the reports of these tumours are scarce and frequently lead to confusion with other entities which present with giant cells. We present the case of a patient with obstructive jaundice and a mixed cystic and solid pancreatic mass, accompanied by multiple hepatic lesions. The histological study of the material obtained by endoscopic ultrasound guided biopsy demonstrated a proliferation of atypical epithelioid cells, accompanied by a spindle cell component with marked pleomorphism and numerous osteoclast-like giant cells. The epithelioid component showed positive immunostaining with cytokeratin cocktail and cytokeratin 7. The spindle cell component showed coexpression of cytokeratins and vimentin. The osteoclast-like giant cells were positive for CD68. Protein p53 was overexpressed in both epithelial and spindle cell neoplastic components, and was negative in the giant cells. These findings permitted the diagnosis of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. This case outlines the effectiveness of endoscopic ultrasound-guided biopsy and the importance of morphological and immunohistochemical examination in the diagnosis of different types of pancreatic tumours, especially when they are in advanced stages and are not suitable for surgical treatment.
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Affiliation(s)
- Daniela Speisky
- Department of Histopathology, Hospital Británico, Buenos Aires C1280AEB, Argentina
| | - Mariano Villarroel
- Department of Gastroenterology, Digestive Endoscopy Section, Hospital Británico, Buenos Aires C1280AEB, Argentina
| | - Félix Vigovich
- Department of Histopathology, Hospital Británico, Buenos Aires C1280AEB, Argentina
| | - Alejandro Iotti
- Department of Histopathology, Hospital Británico, Buenos Aires C1280AEB, Argentina
| | - Teresa Adriana García
- Department of Diagnostic Imaging, Hospital Británico, Buenos Aires C1280AEB, Argentina
| | - Luciana Bella Quero
- Department of Oncology, Hospital Británico, Buenos Aires C1280AEB, Argentina
| | - Mariano Bregante
- Department of General Surgery, Biliopancreatic Area, Hospital Británico, Buenos Aires C1280AEB, Argentina
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Abstract
Pancreatic ductal adenocarcinoma (PDAC), an epithelial neoplasm derived from the pancreatic ductal tree, is the most common histologic type of pancreatic cancer and accounts for 85%-95% of all solid pancreatic tumors. As a highly lethal malignancy, it is the seventh leading cause of cancer death worldwide and is responsible for more than 300 000 deaths per year. PDAC is highly resistant to current therapies, affording patients a 5-year overall survival rate of only 7.2%. It is characterized histologically by its highly desmoplastic stroma embedding tubular and ductlike structures. On images, it typically manifests as a poorly defined hypoenhancing mass, causing ductal obstruction and vascular involvement. Little is known about the other histologic subtypes of PDAC, mainly because of their rarity and lack of specific patterns of disease manifestation. According to the World Health Organization, these variants include adenosquamous carcinoma, colloid carcinoma, hepatoid carcinoma, medullary carcinoma, signet ring cell carcinoma, undifferentiated carcinoma with osteoclast-like giant cells, and undifferentiated carcinoma. Depending on the subtype, they can confer a better or even worse prognosis than that of conventional PDAC. Thus, awareness of the existence and differentiation of these variants on the basis of imaging and histopathologic characteristics is crucial to guide clinical decision making for optimal treatment and patient management.
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Affiliation(s)
- Khoschy Schawkat
- From the Division of Abdominal Imaging, Department of Radiology (K.S., K.J.M.), and Department of Pathology (J.N.G.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02115; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland (K.S.); and American Institute for Radiologic Pathology, Silver Spring, Md, and MedStar Georgetown University Hospital, Washington, DC (M.A.M.)
| | - Maria A Manning
- From the Division of Abdominal Imaging, Department of Radiology (K.S., K.J.M.), and Department of Pathology (J.N.G.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02115; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland (K.S.); and American Institute for Radiologic Pathology, Silver Spring, Md, and MedStar Georgetown University Hospital, Washington, DC (M.A.M.)
| | - Jonathan N Glickman
- From the Division of Abdominal Imaging, Department of Radiology (K.S., K.J.M.), and Department of Pathology (J.N.G.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02115; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland (K.S.); and American Institute for Radiologic Pathology, Silver Spring, Md, and MedStar Georgetown University Hospital, Washington, DC (M.A.M.)
| | - Koenraad J Mortele
- From the Division of Abdominal Imaging, Department of Radiology (K.S., K.J.M.), and Department of Pathology (J.N.G.), Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02115; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland (K.S.); and American Institute for Radiologic Pathology, Silver Spring, Md, and MedStar Georgetown University Hospital, Washington, DC (M.A.M.)
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17
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Abstract
We report a rare case of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UC-OGC) in a 62-year-old female who presented with a three-month history of bilateral flank pain and significant unintentional weight loss. Computed tomography (CT) scan of the abdomen showed pancreatic tail mass, concerning for malignancy. She underwent endoscopic ultrasound (EUS) which also revealed a pancreatic mass invading into the splenic artery. CT chest and positron emission tomography (PET) scan did not reveal any metastases. The patient had a distal pancreatectomy, splenectomy, and left partial adrenalectomy. Histopathology revealed undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (OGCs). The patient was recently started on adjuvant chemotherapy with capecitabine and gemcitabine and the plan is to repeat imaging to assess response. We present this case to increase clinical awareness of this rare clinical entity, and also review controversies in the management and surveillance of UC-OGC.
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Affiliation(s)
- Haisam Abid
- Internal Medicine, Bassett Medical Center, Cooperstown, USA
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18
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Zhang L. Undifferentiated pancreatic carcinoma with osteoclast-like giant cells. Diagn Interv Radiol 2019; 25:173-174. [PMID: 30774096 PMCID: PMC6411267 DOI: 10.5152/dir.2019.18261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 07/09/2018] [Accepted: 07/17/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Lan Zhang
- From the Department of MRI (L.Z. ), the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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19
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Yepuri N, Pruekprasert N, Ramani N, France A, Sarpong JO, Jain A, Cooney RN. 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:rjy341. [PMID: 30591835 PMCID: PMC6302238 DOI: 10.1093/jscr/rjy341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 12/07/2018] [Indexed: 01/14/2023] Open
Abstract
Osteoclast-like giant cell tumor of the pancreas is very rare. We report a 78-year-old male who was previously treated for large mantle cell lymphoma, was found to have an increased uptake in a peri-pancreatic node from his restaging PET scan. Endoscopic ultrasound-directed fine-needle aspiration of the mass and lymph node revealed an undifferentiated carcinoma with osteoclast-like giant cells. Osteoclast-like giant cell tumors of the pancreas are frequently found to be unresectable at diagnosis due to their large size (>5 cm). In our patient, due to its small size (<3 cm) sub-total pancreatectomy was performed. Three years from the surgery, the patient is doing well without recurrence. This case report intends to increase provider awareness that in the setting of new pancreatic lesions in a patient with previous history of lymphoma, a high index of suspicion for a primary pancreatic lesion should be included in the differential diagnosis.
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Affiliation(s)
- Natesh Yepuri
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Napat Pruekprasert
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Nisha Ramani
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Alexandra France
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - James Osei Sarpong
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Ajay Jain
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Robert N Cooney
- Department of Surgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA
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21
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Yazawa T, Watanabe A, Araki K, Segawa A, Hirai K, Kubo N, Igarashi T, Tsukagoshi M, Ishii N, Hoshino K, Kuwano H, Shirabe K. Complete resection of a huge pancreatic undifferentiated carcinoma with osteoclast-like giant cells. Int Cancer Conf J 2017; 6:193-196. [PMID: 31149501 DOI: 10.1007/s13691-017-0305-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 07/24/2017] [Indexed: 12/17/2022] Open
Abstract
Pancreatic undifferentiated carcinoma with osteoclast-like giant cells (PUC-OGC) is a rare neoplasm. We report a case of rapidly advancing PUC-OGC. A 54-year-old man had elevated tumor marker levels. Abdominal computed tomography showed a cystic mass in the body and tail of the pancreas, which infiltrated adjacent organs. The tumor exhibited rapid growth (doubling time: 39 days) but no metastases. We diagnosed PUC-OGC clinically and excised the pancreatic body and tail along with the spleen, left kidney, adrenal gland, and transverse colon. Pathological diagnosis showed histology consistent with PUC-OGC and a negative margin without nodal involvement despite the tumor being 28 cm in maximum diameter and having invaded the left kidney. The patient survived a year with a recurrence of liver metastasis after the initial surgery due to the partial hepatectomy and chemotherapy. Complete resection might be a good strategy to cure PUC-OGC in this case.
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Affiliation(s)
- Tomohiro Yazawa
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
| | - Akira Watanabe
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
| | - Kenichiro Araki
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
| | - Atsuki Segawa
- 2Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511 Japan
| | - Keitaro Hirai
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
| | - Norio Kubo
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
| | - Takamichi Igarashi
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
| | - Mariko Tsukagoshi
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
| | - Norihiro Ishii
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
| | - Kouki Hoshino
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
| | - Hiroyuki Kuwano
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
| | - Ken Shirabe
- 1Department of Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511 Japan
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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; 10:472-478. [PMID: 27721735 PMCID: PMC5043253 DOI: 10.1159/000448878] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 07/29/2016] [Indexed: 01/05/2023] Open
Abstract
Undifferentiated carcinoma of the pancreas (UDC) is rare and has a dismal prognosis. Here, we report a case of 6-year disease-free survival with a mixed type of UDC and UDC with osteoclast-like giant cells, with a high mitotic index as well as perineural, lymphatic, vessel, and diaphragmatic invasion. The patient underwent radical distal pancreatectomy and was subsequently treated with adjuvant chemotherapy using gemcitabine plus S-1 followed by maintenance chemotherapy with oral tegafur-uracil. The patient has been doing well with no evidence of recurrence for more than 6 years after surgery.
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Affiliation(s)
- Hiroyuki Saito
- Department of Surgery, IMS Ota Central General Hospital, Ota, Japan; Department of Surgery, Konosu Kyosei Hospital, Konosu, Japan
| | | | | | - Kazunari Sasaki
- Department of Surgery, IMS Ota Central General Hospital, Ota, Japan
| | - Ryosuke Misawa
- Department of Surgery, IMS Ota Central General Hospital, Ota, Japan
| | - Susumu Ohwada
- Department of Surgery, IMS Ota Central General Hospital, Ota, Japan
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Sekulic M, Gilles S, Amin K, Stewart J 3rd. Undifferentiated (anaplastic) carcinoma with osteoclast-like giant cells of the pancreas: a series of 5 cases with clinicopathologic correlation and cytomorphologic characterization. J Am Soc Cytopathol 2016; 5:321-30. [PMID: 31042543 DOI: 10.1016/j.jasc.2016.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/10/2016] [Accepted: 04/11/2016] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas (UCOGCP) is a rare neoplasm involving the pancreas. Although typically diagnosed initially via endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), cytomorphologic characterization of the neoplasm has been limited to individual cases in the literature. MATERIALS AND METHODS Five cases were identified in a retrospective review of our institution's records from 2006 to 2015. Cytomorphologic, immunophenotypic, and corresponding clinical features of the neoplasm are examined and described. RESULTS UCOGCP accounted for 0.9% of all new pancreatic neoplastic diagnoses, had a median greatest dimension of 4.3 cm, were variably located within the pancreas, and had variable features by radiologic imaging. Patients were of a median age of 78 years old at diagnosis, and had a median length of survival of 10 months. Smear-based cytomorphology and histomorphology from cell block preparations show atypical/pleomorphic mononuclear carcinomatous and bland osteoclast-like giant cellular populations. The immunophenotype of the mononuclear carcinomatous component was CD68, CD99, CK7 (variably), CKAE1/AE3 (variably), and, rarely, p40-positive. The osteoclast-like giant cells positively expressed CD68 and CD99. CONCLUSIONS Initial diagnosis of UCOGCP is frequently made via EUS-FNA of pancreas tumors, with cytomorphologic features on smears and hematoxylin and eosin stained slides prepared from cell block material being characteristic for the diagnosis. Although the cellular constituents have a consistent immunophenotype, the diagnosis can be based on the morphologic features alone. UCOGCP is an important diagnosis as it may have a distinct clinical course from undifferentiated carcinomas of the pancreas lacking osteoclast-like giant cells.
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Yang KY, Choi JI, Choi MH, Park MY, Rha SE, Byun JY, Jung ES, Lall C. Magnetic resonance imaging findings of undifferentiated carcinoma with osteoclast-like giant cells of pancreas. Clin Imaging 2016; 40:148-51. [DOI: 10.1016/j.clinimag.2015.09.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 08/13/2015] [Accepted: 09/15/2015] [Indexed: 10/23/2022]
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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 2015; 19:106-8. [PMID: 26745313 PMCID: PMC4756204 DOI: 10.1016/j.ijscr.2015.12.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 12/16/2015] [Accepted: 12/16/2015] [Indexed: 01/25/2023] Open
Abstract
Pancreatic undifferentiated carcinomas with OGCs are very rare neoplasms that may have an atypical clinical presentation. Less than a hundred cases have been described until today. Early diagnosis and aggressive surgical treatment is the only way to prolong survival.
Introduction Undifferentiated head of pancreas carcinoma with osteoclast-like giant cells (UC-OGC) is a rare neoplasm, with less than a hundred cases reported. We present such a case, in which the UC-OGC presented atypically as a cystic lesion following acute pancreatitis and led to late diagnosis. Presentation of case A 75-year-old female patient, who had suffered acute pancreatitis three years ago, was referred with a diagnosis of osteoclast-like giant cell (OGC) tumor of the head of pancreas. She had suffered acute pancreatitis three years ago. Two years ago she developed abdominal pain, steatorrhea and weight loss. Abdominal computed tomography imaging showed a cystic mass in the head of the pancreas (maximum diameter 4 cm). The initial diagnosis was pancreatic pseudocyst; however as the mass gradually increased in size and the patient continued to be symptomatic, a CT-guided biopsy was performed. Histological examination revealed an OGC pancreatic tumor. In laparotomy a large (9 cm) encapsulated heterogeneous mass was found with partial involvement of the common hepatic artery. Pancreaticoduodenectomy was performed and the involved part of the common hepatic artery was replaced with a homologous graft from the major saphenous vein. Post-operative course was uneventful. Histology revealed an undifferentiated pancreatic adenocarcinoma with OGCs. She survived 10 months after the operation. Discussion Pancreatic undifferentiated carcinomas with OGCs are very rare neoplasms and can present with an atypical clinical picture. Conclusions A symptomatic cystic lesion of the pancreas, which is growing in size, should be investigated promptly in order to exclude the presence of malignancy.
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Affiliation(s)
- Georgios Κ Georgiou
- Department of Surgery, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500 Ioannina, Greece.
| | - Ephimia Balasi
- Department of Histopathology, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500 Ioannina, Greece
| | - Vasiliki Siozopoulou
- Department of Histopathology, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500 Ioannina, Greece
| | - Athina Tsili
- Department of Radiology, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500 Ioannina, Greece
| | - Michalis Fatouros
- Department of Surgery, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500 Ioannina, Greece
| | - Georgios Glantzounis
- Department of Surgery, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500 Ioannina, Greece
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26
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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; 8:11785-11791. [PMID: 26617927 PMCID: PMC4637743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 08/25/2015] [Indexed: 06/05/2023]
Abstract
Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UCPOGC) is an extremely rare non-endocrine pancreatic tumor. To date, some cases have been reported, however, histogenesis and biologic behavior of UCPOGC remain controversial. We report a case of an UCPOGC in a 54-year-old female, who presented with a three-month history of recurrent abdominal pain without any incentive. Abdominal computed tomography (CT) revealed a large cystic mass of 10.5 × 9.3 cm in the body and tail of the pancreas compressing the adjacent bowel loop and stomach. The preliminary diagnosis was considered as a malignant tumor of body and tail of the pancreas. The patient had open distal pancreatic mass resection with splenectomy and according to the results of histopathological and immunohistochemical studies, the diagnosis of an UCPOGC was established.
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Affiliation(s)
- Shambhu K Sah
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University Chongqing 400016, China
| | - Ying Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University Chongqing 400016, China
| | - Yongmei Li
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University Chongqing 400016, China
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27
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Dahm HH. Immunohistochemical evaluation of a sarcomatoid hepatocellular carcinoma with osteoclastlike giant cells. Diagn Pathol 2015; 10:40. [PMID: 25928039 PMCID: PMC4411821 DOI: 10.1186/s13000-015-0274-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 04/16/2015] [Indexed: 12/04/2022] Open
Abstract
Background Malignant liver tumors with osteoclast-like giant cells are rare. A literature search showed 17 previously reported cases that included the following: (1) 8 undifferentiated hepatocellular carcinomas, (2) 5 sarcomatous tumors with osteoclast-like giant cells associated with intrahepatic cholangiocarcinoma or liver cystadenocarcinoma, and (3) 4 sarcomatoid tumors with osteoclast-like giant cells associated with areas of a conventional hepatocellular carcinoma. Case presentation A 68-year-old man presented with a tumor of the right lobe of the liver on ultrasonography and computed tomography. Laparoscopy showed a tumor (diameter, 4 cm) in segments 7 and 8 of the right liver lobe that adhered to the retroperitoneum. The tumor recurred 3 months after liver segmentectomy. Repeat laparoscopy showed diffuse and nodular metastases to the omentum and peritoneum. Result Light microscopy showed that part of the tumor had features of classic hepatocellular carcinoma. Another part of the tumor had a solid sarcomatous pattern with osteoclast-like giant cells that were irregularly distributed between the smaller undifferentiated tumor cells; cells of this part of the tumor were positive for heppar-1. Conclusion Light microscopic findings including osteoclast-like giant cells, and the strong reaction of heppar-1 antibody with cells of the sarcomatous part of the tumor, confirmed that this sarcomatous element was a metaplastic or transformed portion of hepatocellular carcinoma. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/6000512901462616 Electronic supplementary material The online version of this article (doi:10.1186/s13000-015-0274-4) contains supplementary material, which is available to authorized users.
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Dioscoridi L, Bisogni D, Freschi G. Hepatocellular carcinoma with osteoclast-like giant cells: report of the seventh case in the literature. Case Rep Surg 2015; 2015:836105. [PMID: 25793139 DOI: 10.1155/2015/836105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/12/2015] [Indexed: 11/17/2022] Open
Abstract
Hepatocellular carcinoma with osteoclast-like giant cells is extremely rare, and only six cases have been previously reported. Its histogenesis is at the moment controversial. The authors report a case of hepatocellular carcinoma with osteoclast-like giant cells found in a 74-year-old woman. The patient came with a dull pain in the right upper abdominal quadrants due to a liver neoplasm described at CT scan. A wedge resection of the fifth hepatic segment with appendectomy, omentectomy, and debulking of the major peritoneal implants was performed. Histologically, the diagnosis of hepatocellular carcinoma with high grade differentiation associated with giant osteoclast-like cells was done without any evidence of hepatitis or cirrhosis in the surrounding hepatic parenchyma. Immunohistochemistry was positive for CD10 and CD68 and in situ hybridization revealed the expression of receptor activator of nuclear factor-kappa B (RANK) in the giant cells and receptor activator of nuclear factor-kappa B ligand (RANKL) in the tumor cells.
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29
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Alemán-Meza L, Gómez-Macías GS, Barboza-Quintana O, Garza-Guajardo R, Loya-Solis A. Osteoclastic giant cell rich squamous cell carcinoma of the uterine cervix: a case report and review of the literature. Case Rep Pathol 2014; 2014:415328. [PMID: 25587478 DOI: 10.1155/2014/415328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 12/02/2014] [Accepted: 12/10/2014] [Indexed: 11/29/2022] Open
Abstract
Cervical carcinoma is the most common malignancy of the female genital tract and represents the second most common malignancy in women worldwide. Histologically 85 to 90% of cervical cancers are squamous cell carcinoma. Osteoclastic giant cell rich squamous cell carcinoma is an unusual histological variant of which only 4 cases have been reported. We present the case of a 49-year-old woman with a 6-month history of irregular vaginal bleeding. Examination revealed a 2.7 cm polypoid mass in the anterior lip of the uterine cervix. The patient underwent hysterectomy with bilateral salpingo-oophorectomy. Microscopically the tumor was composed of infiltrative nests of poorly differentiated nonkeratinizing squamous cell carcinoma. Interspersed in between these tumor cells were numerous osteoclastic giant cells with abundant eosinophilic cytoplasm devoid of nuclear atypia, hyperchromatism, or mitotic activity. Immunohistochemistry was performed; CK and P63 were strongly positive in the squamous component and negative in the osteoclastic giant cells, while CD68 and Vimentin were strongly positive in the giant cell population and negative in the squamous component. The patient received chemo- and radiotherapy for recurrent disease identified 3 months later on a follow-up CT scan; 7 months after the surgical procedure the patient is clinically and radiologically disease-free.
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Njoumi N, Elalami FH, Attolou G, Saoud O, Elabsi M, Echarrab M, Elouannani M, Errougani A, Amraoui M, Chkoff MR. Undifferentiated pancreatic carcinoma with osteoclast-like giant cells: a case report. J Gastrointest Cancer 2014; 45 Suppl 1:96-8. [PMID: 24382600 PMCID: PMC4292047 DOI: 10.1007/s12029-013-9572-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Noureddine Njoumi
- Department of Visceral Surgical Emergency, Ibn Sina Hospital, CHU Ibn Sina, Rabat, Morocco,
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Affiliation(s)
- Yoshiyuki Wada
- Department of Hepato-Biliary-Pancreas Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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Kolokotronis T, Glanemann M, Wagner M, Bohle RM, Grünhage F. Giant cell tumor of the distal common bile duct: report of a rare, benign entity that may mimic malignant biliary obstruction. Int J Colorectal Dis 2014; 29:413-4. [PMID: 24287577 DOI: 10.1007/s00384-013-1798-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2013] [Indexed: 02/04/2023]
Affiliation(s)
- Theodoros Kolokotronis
- Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland Medical School, Homburg Campus, 66421, Homburg, Saar, Germany,
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Temesgen WM, Wachtel M, Dissanaike S. Osteoclastic giant cell tumor of the pancreas. Int J Surg Case Rep 2014; 5:175-9. [PMID: 24631915 PMCID: PMC3980420 DOI: 10.1016/j.ijscr.2014.01.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 12/19/2013] [Accepted: 01/02/2014] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Pancreatic giant cell tumors are rare, with an incidence of less than 1% of all pancreatic tumors. Osteoclastic giant cell tumor (OGCT) of the pancreas is one of the three types of PGCT, which are now classified as undifferentiated carcinoma with osteoclast-like giant cells. PRESENTATION OF CASE The patient is a 57 year old woman who presented with a 3 week history of epigastric pain and a palpable abdominal mass. Imaging studies revealed an 18 cm × 15 cm soft tissue mass with cystic components which involved the pancreas, stomach and spleen. Exploratory laparotomy with distal pancreatectomy, partial gastrectomy and splenectomy was performed. Histology revealed undifferentiated pancreatic carcinoma with osteoclast-like giant cells with production of osteoid and glandular elements. DISCUSSION OGCT of the pancreas resembles benign-appearing giant cell tumors of bone, and contain osteoclastic-like multinucleated cells and mononuclear cells. OGCTs display a less aggressive course with slow metastasis and lymph node spread compared to pancreatic adenocarcinoma. Due to the rarity of the cancer, there is a lack of prospective studies on treatment options. Surgical en-bloc resection is currently considered first line treatment. The role of adjuvant therapy with radiotherapy or chemotherapy has not been established. CONCLUSION Pancreatic giant cell tumors are rare pancreatic neoplasms with unique clinical and pathological characteristics. Osteoclastic giant cell tumors are the most favorable sub-type. Surgical en bloc resection is the first line treatment. Long-term follow-up of patients with these tumors is essential to compile a body of literature to help guide treatment.
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Affiliation(s)
- Wudneh M Temesgen
- Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430, United States.
| | - Mitchell Wachtel
- Department of Pathology, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430-8115, United States.
| | - Sharmila Dissanaike
- Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430, United States.
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Shah A, Khurana T, Freid L, Siddiqui AA. Undifferentiated Carcinoma with Osteoclast-Like Giant Cells of the Pancreas in a Patient with New Diagnosis of Follicular Non-Hodgkin's Lymphoma. ACG Case Rep J 2014; 1:109-11. [PMID: 26157841 DOI: 10.14309/crj.2014.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 01/03/2013] [Indexed: 11/23/2022] Open
Abstract
Pancreatic tumors with osteoclast-like giant cells are rare, with only 50 cases published to date. We report a case of a 67-year-old male with a new diagnosis of follicular non-Hodgkin's lymphoma with an incidental pancreatic body mass on abdominal imaging. Cytology from the pancreatic mass obtained via endoscopic ultrasound-directed fine-needle aspiration (EUS-FNA) revealed an undifferentiated carcinoma with osteoclast-like giant cells.
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Yoshioka M, Uchinami H, Watanabe G, Takahashi T, Nakagawa Y, Andoh H, Yoshioka T, Nanjo H, Yamamoto Y. 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; 51:2145-50. [PMID: 22892493 DOI: 10.2169/internalmedicine.51.7670] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
A 74-year-old woman had an undifferentiated carcinoma with osteoclast-like giant cells (UCWOGC) in the body of the pancreas with massive portal vein tumor thrombus (PVTT). Because the PVTT progressed so rapidly into the right portal branch, the patient first underwent distal pancreatectomy and tumor thrombectomy to prevent life-threatening portal venous obstruction. Although a recurrent PVTT had developed early postoperatively, systemic gemcitabine treatment was so effective that it induced complete remission 5 months after the initiation of chemotherapy. The patient continued to be in complete response for 12 months, and has survived for 19 months since surgery.
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Affiliation(s)
- Masato Yoshioka
- Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Japan.
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Rastogi A, Bihari C, Jain D, Gupta NL, Sarin SK. Hepatocellular carcinoma presenting with multiple bone and soft tissue metastases and atypical cytomorphological features--a rare case report. Diagn Cytopathol 2011; 41:640-3. [PMID: 21965139 DOI: 10.1002/dc.21838] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Accepted: 08/11/2011] [Indexed: 12/14/2022]
Abstract
Hepatocellular carcinoma (HCC) with atypical cytomorphological features and presenting with bone and soft tissue metastasis is very rare. We report a 65-year-old male patient of HCC who presented with bone and soft tissue metastases and was clinically and radiologically suspected to have a soft tissue sarcoma. The patient presented with severe cervical pain with palpable masses in right scapular, nape of neck, and occiput area of scalp. Radiologically, these were large, bulky soft tissue masses expansile, destructive, and lytic in nature. Cytomorphologic studies revealed HCC with uncommon features of multinucleated osteoclast-like giant cell and very prominent intracytoplasmic hyaline bodies (IHBs). Cytology, immunohistochemistry on cell block preparation, rising serum α-fetoprotein (AFP) levels (1121.93-5000 ng/ml), and PIVKA II levels confirmed the diagnosis. The patient has been on follow-up on sorafinib for 2 months and is doing well. This case emphasizes the need for systematic approach in cases of HCC with atypical clinical presentation and unusual cytomorphology.
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Affiliation(s)
- Archana Rastogi
- Department of Pathology, Institute of Liver and Biliary Sciences, New Delhi, India.
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Hur YH, Kim HH, Seoung JS, Seo KW, Kim JW, Jeong YY, Lee JH, Koh YS, Kim JC, Kim HJ, Cho CK. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. J Korean Surg Soc 2011; 81:146-50. [PMID: 22066115 PMCID: PMC3204565 DOI: 10.4174/jkss.2011.81.2.146] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 12/06/2010] [Indexed: 01/27/2023]
Abstract
Undifferentiated carcinoma with osteoclast-like giant cells is a rare neoplasm of the exocrine pancreas. Some similar cases have been reported, but the histogenesis of these tumors varies and is controversial. We report here on a case of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. A 77-year old woman presented with abdominal pain and anorexia. Abdominal computed tomography and magnetic resonance imaging showed an approximately 10 × 5 cm highly attenuated mass arising from the tail of the pancreas and invading the spleen and adjacent bowel loop. The initial impression was a malignant endocrine tumor or solid-pseudopapillary tumor of the pancreas. The patient underwent a distal pancreatectomy with splenectomy and left hemicolectomy. The histopathology and immunohistochemistry helped make the diagnosis that of an undifferentiated carcinoma with osteoclast-like giant cells of the pancreas.
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Affiliation(s)
- Young Hoe Hur
- Division of Hepatico Biliary Pancreatic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
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Rustagi T, Rampurwala M, Rai M, Golioto M. Recurrent acute pancreatitis and persistent hyperamylasemia as a presentation of pancreatic osteoclastic giant cell tumor: an unusual presentation of a rare tumor. Pancreatology 2011; 11:12-5. [PMID: 21311208 DOI: 10.1159/000323210] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Giant cell tumors of the pancreas are rare neoplasms divided into three forms: osteoclastic, pleomorphic, and mixed. We report an unusual case of a 62-year-old male presenting with recurrent acute pancreatitis and found to have a mass in the head of the pancreas on routine imaging. Endoscopic retrograde cholangiopancreatography showed a main pancreatic duct stricture, with brush cytology revealing the diagnosis of osteoclastic giant cell tumor of the pancreas. Whipple's procedure was successfully performed for resection of this tumor. and IAP.
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Affiliation(s)
- Tarun Rustagi
- Department of Internal Medicine, University of Connecticut, Farmington, CT 06032, USA. trustagi @ resident.uchc.edu
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Togawa Y, Tonouchi A, Chiku T, Sano W, Doki T, Yano K, Uno H, Muronoi T, Kaneoya K, Shinagawa T, Harigaya K, Toyoda A. A case report of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas and literature review. Clin J Gastroenterol 2010; 3:195-203. [PMID: 26190247 DOI: 10.1007/s12328-010-0160-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 06/06/2010] [Indexed: 02/07/2023]
Abstract
Osteoclast-like giant cell tumors rarely arise in the pancreas. Here we report the case of a 78-year-old woman who was diagnosed with a well-defined 3 cm multilocular mass in the pancreatic body by the use of ultrasonography, computed tomography and magnetic resonance imaging. The rim and the septa of the tumor were well enhanced. The distal pancreas was removed with the spleen and the peripancreatic lymph nodes. Macroscopically, the mass was composed predominantly of a multilocular cystic tumor filled with hemorrhagic necrosis, and partly composed of solid components. A histopathological study showed a proliferation of multinucleated osteoclast-like giant cells and spindle cells. Although the predominant tumor cells were strongly positive for vimentin and CD68 and negative for epithelial markers, there were some sparsely scattered cytokeratin-positive neoplastic glands. Seventeen months after surgery, the patient is still alive and has had no recurrence. Below we review 32 cases of osteoclast-like giant cell tumor of the pancreas that have been reported in English literature since 2000.
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Affiliation(s)
- Yasuhiro Togawa
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan.
| | - Akihiko Tonouchi
- Department of Surgery, Saitama Red Cross Hospital, 8-3-33 Kamiochiai, Chuou, Saitama, Saitama, 338-8553, Japan
| | - Tsuyoshi Chiku
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Wataru Sano
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Tomoko Doki
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Kentaro Yano
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Hidehiko Uno
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Tomohiro Muronoi
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Katsuhiko Kaneoya
- Department of Radiology, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Takashi Shinagawa
- Department of Gastroenterology, Kamitsuga General Hospital, 1-1033, Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Kenichi Harigaya
- Department of Molecular and Tumor Pathology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou, Chiba, Chiba, 260-8677, Japan
| | - Akihiro Toyoda
- Department of Molecular and Tumor Pathology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou, Chiba, Chiba, 260-8677, Japan
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Tanahashi C, Nagae H, Nukaya T, Hasegawa M, Yatabe Y. Combined hepatocellular carcinoma and osteoclast-like giant cell tumor of the liver: Possible clue to histogenesis. Pathol Int 2009; 59:813-6. [DOI: 10.1111/j.1440-1827.2009.02450.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Shah S, Mortele KJ. Uncommon solid pancreatic neoplasms: ultrasound, computed tomography, and magnetic resonance imaging features. Semin Ultrasound CT MR 2008; 28:357-70. [PMID: 17970552 DOI: 10.1053/j.sult.2007.08.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This article reviews the ultrasound, computed tomography, and magnetic resonance imaging features of rare solid tumors of the pancreas with attention to distinctive imaging appearances, which can help radiologists to discriminate between the different entities. Various uncommon solid pancreatic neoplasms, including exocrine and endocrine epithelial tumors, mesenchymal tumors, and metastases, are reviewed, with emphasis on key differential points, including morphologic features and patterns of contrast enhancement.
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Affiliation(s)
- Sejal Shah
- Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA
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Sarma DP, Santos EE, Wang B. Leiomyosarcoma of the skin with osteoclast-like giant cells: a case report. J Med Case Rep 2007; 1:180. [PMID: 18081931 PMCID: PMC2245960 DOI: 10.1186/1752-1947-1-180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Accepted: 12/14/2007] [Indexed: 12/05/2022] Open
Abstract
Introduction Osteoclast-like giant cells have been noted in various malignant tumors, such as, carcinomas of pancreas and liver and leiomyosarcomas of non-cutaneous locations, such as, uterus and rectum. We were unable to find any reported case of a leiomyosarcoma of the skin where osteoclast-like giant cells were present in the tumor. Case presentation We report a case of a 59-year-old woman with a cutaneous leiomyosarcoma associated with osteoclast-like giant cells arising from the subcutaneous artery of the leg. The nature of the giant cells is discussed in light of the findings from the immunostaining as well as survey of the literature. Conclusion A rare case of cutaneous leiomyosarcoma with osteoclast-like giant cells is reported. The giant cells in the tumor appear to be reactive histiocytic cells.
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Affiliation(s)
- Deba P Sarma
- Department of Pathology, Creighton University Medical Center, Omaha, NE 68131, USA.
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