Cross‐classification and survival characteristics of 5,000 cases of cancer of the pancreas

Baylor, Stephen M.; Berg, John W.

doi:10.1002/jso.2930050410

Cited by 224 publications

(137 citation statements)

References 13 publications

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“…Adenosquamous carcinoma is included among the histologic variants of pancreatic carcinoma that have been delineated in several studies (6,15,16). As mentioned above, a number of synonyms have been applied to adenosquamous carcinoma since its initial description as "cancroide."…”

Section: Discussionmentioning

confidence: 99%

“…It is our opinion that primary tumors of the pancreas that show any degree of definitive malignant squamous cell differentiation on routine sectioning should be considered adenosquamous carcinoma. Furthermore, it has been suggested in the medical literature that squamous cell carcinoma occurs de novo within the pancreas without an identifiable ductal component (16,(21)(22)(23). Based on our review of these publications, there was either limited diagnostic material or no resection specimen, or the cases were presented as part of a large series of pancreatic cancer, which did not specify the details of the individual cases.…”

Section: Discussionmentioning

confidence: 99%

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Adenosquamous Carcinoma Of The Pancreas: A Clinicopathologic Series Of 25 Cases

et al. 2001

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Background: Adenosquamous carcinoma is a rare aggressive subtype of pancreatic adenocarcinoma. We describe the clinical, pathologic, and molecular characteristics of 25 of these lesions, the largest series to date. Methods: Twenty-five cases of adenosquamous carcinoma of the pancreas diagnosed between 1961 and 1994 were retrieved from the files of the Endocrine Registry of the Armed Forces Institute of Pathology. Histologic features were reviewed, histochemical, immunohistochemical, and molecular (k-ras) studies were performed, and patient follow-up was obtained. Results: The patients included 17 men and eight women, aged 28 to 82 years (mean, 65.4 y). The patients usually experienced weight loss (n ‫؍‬ 17) or painless jaundice (n ‫؍‬ 11), while also presenting with other abdominal symptoms. The tumors affected the head most frequently (n ‫؍‬ 17), followed by the tail (n ‫؍‬ 9) or body (n ‫؍‬ 4). Five cases involved more than one anatomic region of the pancreas. Microscopically, all tumors demonstrated dual differentiation toward adenocarcinoma and squamous cell carcinoma. All cases tested were immunoreactive with keratin (AE1:AE3 and CK1), whereas other keratin markers were variably expressed: CK5/6 (88%), CK7 (68%), Cam5.2 (41%), and CK20(26%). CA-19 -9 (84%) and CEA (74%) were positive in the majority of the cases. K-ras oncogene mutations were identified in seven of 13 cases. All patients died from their disease an average of 5.8

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adenosquamous Carcinoma Of The Pancreas: A Clinicopathologic Series Of 25 Cases

et al. 2001

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“…In addition, the majority of primary pancreatic sarcomas have been leiomyosarcomas (1)(2)(3)(4)(5)(6)(7). This suggests that mesenchymal malignancies arising within the pancreas may have a proclivity toward myogenous differentiation.…”

Section: Discussionmentioning

confidence: 99%

“…Primary sarcomas of the pancreas are rare (1)(2)(3)(4)(5)(6)(7), with fewer than a dozen leiomyosarcomas and a single liposarcoma being reported in the English language literature. Rarer still are malignant islet cell tumors with sarcomatous differentiation.…”

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confidence: 99%

Malignant Islet Cell Tumor with Sarcomatous Differentiation

et al. 2001

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Malignant mesenchymal neoplasms of the pancreas are rare and malignant islet cell tumors with sarcomatous dedifferentiation are rarer still. We present a case of malignant islet cell tumor with sarcomatous differentiation, which to our knowledge is only the second reported case showing such a combination of morphologic features. Clinically, the neoplasm was not hormonally active and immunohistochemical staining was negative for gastrin, glucagon, insulin and somatostatin. The sarcomatous component strongly reacted with an antibody directed against vimentin, and a minority of cells stained strongly with antisera directed against desmin and smooth muscle actin. Primary sarcomas of the pancreas are rare (1-7), with fewer than a dozen leiomyosarcomas and a single liposarcoma being reported in the English language literature. Rarer still are malignant islet cell tumors with sarcomatous differentiation. Only a single case report of such a combined neoplasm has to our knowledge appeared in the English language literature (8).The histomorphologic spectrum of carcinoid tumors is wide with glandular morphologies, papillary structures, oncocytic changes, squamous and osseous metaplasia and spindle cell patterns being recognized (9 -14). The spindle cell pattern described by Rosai et al. (14) appears to be unrelated to the sarcomatous changes seen in our case and that described by Ferreiro et al. (8). We report a case of pancreatic carcinoid (islet cell tumor) with focal myosarcomatous differentiation, which is to our knowledge only the second such case reported in the English language literature. CASE REPORTThe patient, a 61-year-old Caucasian female, was followed at the University of Utah for gastroesophageal reflux of long duration controlled by Prilosec. An ultrasound of the abdomen was obtained 3 months before admission to investigate the patient's complaint of vague abdominal pain. A lesion was visualized around the liver, and endoscopy was performed, which revealed a Barrett's esophagus without dysplasia. A follow-up CT scan demonstrated a 10 cm heterogenous mass in the tail of the pancreas (Fig. 1) and three lesions in her liver. The patient's clinical history was otherwise unremarkable except for back pain, most noticeable when lying in bed. Physical examination failed to reveal icterus or lymphadenopathy. The patient underwent exploratory laparotomy with intraoperative biopsy and frozen section of the largest of the liver lesions. Frozen section revealed a hemangioma, and the pancreatic mass was then resected. The postoperative course was unremarkable, and no metastatic lesions have been detected in the immediate postoperative period. METHODSRepresentative tissue sections were taken from the specimen, fixed in 10% neutral buffered forma-

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“…Squamous cell carcinpmais a rare form ofpancreatic cancer that is derived from ductal cells, with most studies citing an incidence of about 0.5-2.0% (1)(2)(3)(4)(5). Wereport an unusual case of squamous cell carcinoma of the pancreas; a small tumor in the uncinate process close to the third portion of the duodenum had massively invaded the retroperitoneal region.…”

Section: Introductionmentioning

confidence: 99%

Squamous Cell Carcinoma of the Pancreas with Massive Invasion of the Retroperitoneum.

Nakashima

Hayakawa²,

Hoshino³

et al. 1995

Intern. Med.

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A 79-year-old womanwith a rare form of pancreatic carcinoma with massive invasion of the retroperitoneum presented with upper abdominal pain and vomiting. Although examination (computed tomography, barium enema, upper gastrointestinal series) suggested peritonitis carcinomatosa due to pancreatic cancer, a primary lesion of the pancreas was not confirmed by endoscopic retrograde pancreatography. Autopsy ultimately revealed a small tumor (5x8 mm)of the uncinate process of the pancreas near the duodenumwith peritonitis carcinomatosa. Microscopically, the tumor and its metastasis consisted of poorly differentiated squamous cell carcinoma without adenocarcinomatous change, a rare form of pancreatic tumor. (Internal Medicine 34: 61-64, 1995)

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Cross‐classification and survival characteristics of 5,000 cases of cancer of the pancreas

Cited by 224 publications

References 13 publications

Adenosquamous Carcinoma Of The Pancreas: A Clinicopathologic Series Of 25 Cases

Adenosquamous Carcinoma Of The Pancreas: A Clinicopathologic Series Of 25 Cases

Malignant Islet Cell Tumor with Sarcomatous Differentiation

Squamous Cell Carcinoma of the Pancreas with Massive Invasion of the Retroperitoneum.

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