Giant cell tumor of the pancreas of mixed osteoclastic and pleomorphic cell type: Evidence for a histogenetic relationship and mesenchymal differentiation

Lewandrowski, Kent; Weston, Lynn A.; Dickersin, G. Richard; Rattner, David W.; Compton, Carolyn C.

doi:10.1016/0046-8177(90)90157-z

Cited by 58 publications

(54 citation statements)

References 7 publications

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“…In our series, no patients had any vascular involvement, a highly unusual finding for patients with large, bulky pancreatic tumors. Three patients in our series had malignant lymph nodes on diagnosis, in contrast to reported literature which tend to find an absence of malignant adenopathy [2,11] .…”

Section: Imagingcontrasting

confidence: 53%

“…OGCT of the pancreas are less aggressive and may confer a better prognosis when compared to either pancreatic adenocarcinoma or PGCT [11,26,27] . Osteoclastic giant cell tumors may metastasize more slowly.…”

Section: Clinical Course and Discussionmentioning

confidence: 99%

“…Some authors have divided GCT further into two distinct types [11] . Osteoclastic-giant cell tumors are neoplasms dominated by benign-appearing osteoclastlike giant-cells closely resembling conventional giant-cell tumor of bone [12] .…”

Section: Introductionmentioning

confidence: 99%

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Osteoclastic and pleomorphic giant cell tumors of the pancreas: A review of clinical, endoscopic, and pathologic features

Moore

Bentz²,

Hilden³

et al. 2010

WJG

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Giant cell tumors of the pancreas come in three varieties-osteoclastic, pleomorphic, and mixed histology. These tumors have distinctive endoscopic, clinical, and cytological features. Giant cell tumors have a controversial histogenesis, with some authors favoring an epithelial origin and others favoring a mesenchymal origin. The true origin of these lesions remains unclear at this time. These are also very rare tumors but proper identification and differentiation from more common pancreatic adenocarcinoma is important. The risk factors of these tumors and the prognosis may be different from those associated with standard pancreatic adenocarcinoma. Recognition of these differences can significantly affect patient care. These lesions have a unique appearance when imaged with endoscopic ultrasound (EUS), and these lesions can be diagnosed via EUS guided Fine Needle Aspiration (FNA). This manuscript will review the endoscopic, clinical, and pathologic features of these tumors.

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Section: Imagingcontrasting

confidence: 53%

Section: Clinical Course and Discussionmentioning

confidence: 99%

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Osteoclastic and pleomorphic giant cell tumors of the pancreas: A review of clinical, endoscopic, and pathologic features

Moore

Bentz²,

Hilden³

et al. 2010

WJG

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“…23 The latter possibility is supported by the occurrence of mixed ductal adenocarcinoma-pleomorphic giant cell tumor on the one hand and osteoclastic and pleomorphic giant cells on the other. 15,24 Our finding supports the precursor (stem) cell derivation of giant cell carcinoma. Because the tumor was induced only when islet and not ductal cells were treated with the carcinogen, we concluded that some cells within islets present the tumor progenitor cells.…”

Section: Discussionsupporting

confidence: 77%

In Vitro Induction of Giant Cell Tumors from Cultured Hamster Islets Treated with N-Nitrosobis(2-Oxopropyl)amine

Matsuzaki

Schmied

Ulrich

et al. 2000

The American Journal of Pathology

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It is generally believed that over 90% of pancreatic cancers originate from ductal/ductular cells. Studies of the hamster pancreatic cancer model, which in biological and morphological aspects mimics human tumors, [1][2][3] however, have shown that pancreatic ductal adenocarcinoma originates not only from ductal/ductular cells but primarily from within islets, most probably from precursor (stem) cells.

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“…8 Those in favor of a mesenchymal derivation point to the striking resemblance of OGCT to osteoclastic giant cell tumor of bone. 9 Lewandrowskiet al 1 carried out ultrastructuraland immunohistochemical studies on a mixed osteoclastic and pleomorphic giant cell tumor of the pancreas, and their results strongly supported a mesenchymal line of differentiation. However, this may very well be a collision tumor, or a dual growth of two distinct malignancies.…”

Section: Discussionmentioning

confidence: 99%

Mixed Osteoclastic and Pleomorphic Giant Cell Carcinoma of the Pancreas

Bhattachan

Khan

1998

Ann Saudi Med

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True mixed giant cell tumors of the pancreas 1 that are composed of osteoclastic 2 and pleomorphic 3 giant cells are quite rare. Three such cases have been reported previously in the English literature, but ours is the first case from Saudi Arabia. The biologic behavior of osteoclastic giant cell tumors (OGCT) 4 is that of a locally aggressive lowgrade malignancy, in contrast to pleomorphic giant cell tumors (PGCT), which behave in a highly malignant fashion. The behavior of true mixed giant cell tumors (OGCT+PGCT) is not known, because of the limited number of cases. Our case, which was a true mixed tumor of giant cells, behaved in a highly aggressive manner. In this report we document that if pleomorphism is seen among giant cell tumors of the pancreas, then such tumors should be regarded as highly malignant and be treated accordingly. Case ReportA previously healthy 65-year-old Saudi male presented with a four-month history of left upper quadrant pain radiating to the back, and associated with considerable anorexia and recent onset of weight loss. There was no prior history of gastrointestinal disease or pancreatitis. Examination revealed an ill-defined non-tender mass near the left hypochondrium without any evidence of peritoneal irritation. There was no palpable lymphadenopathy or hepatosplenomegaly.Laboratory evaluation revealed normochromic, normocytic anemia. Liver function tests were normal. Serum chemistry levels such as urea, creatinine, glucose and electrolytes were also within normal limits. Stool examination revealed no parasitic ova or occult blood. The urine examination was normal. An ultrasound examination of the abdomen revealed an ill-defined mass on the posterior abdominal wall related to the body and tail of the pancreas. CT scan demonstrated a tumor arising from thejunction of the body and tail of the pancreas, measuring about 20 cm. A roentgenogram of the chest showed mild cardiomegaly with subsegmental left basilar atelectasis. Endoscopy of the upper gastrointestinal tract was normal, however, it was not possible to negotiate beyond the descending colon on flexible colonoscopy. Barium enema showed a cutoff near the splenic flexure. At this point, it was decided to perform an explorative laparotomy through a midline incision, which revealed a tumor arising from the junction of the body and tail of the pancreas. The tumor was firm, dark, hemorrhagic and irregular-shaped, with some cystic areas. There was no evidence of any local invasion or liver metastases. Subtotal distal pancreaticosplenectomy was performed, which resulted in temporary improvement of the patient's condition. The patient was discharged home two weeks after the operation. He was readmitted four months later because of anorexia and continued weight loss. A thorough workup did not reveal any recurrence or metastases from the tumor. Supportive treatment was instituted, but the patient died about five months after the operation.Histopathological examination (Figure 1) revealed a tumor containing abundant multinucleated osteo...

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Giant cell tumor of the pancreas of mixed osteoclastic and pleomorphic cell type: Evidence for a histogenetic relationship and mesenchymal differentiation

Cited by 58 publications

References 7 publications

Osteoclastic and pleomorphic giant cell tumors of the pancreas: A review of clinical, endoscopic, and pathologic features

Osteoclastic and pleomorphic giant cell tumors of the pancreas: A review of clinical, endoscopic, and pathologic features

In Vitro Induction of Giant Cell Tumors from Cultured Hamster Islets Treated with N-Nitrosobis(2-Oxopropyl)amine

Mixed Osteoclastic and Pleomorphic Giant Cell Carcinoma of the Pancreas

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