Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells showing intraductal growth and intratumoral hemorrhage: MRI features

Sato, Keisuke; Urakawa, Hiroshi; Sakamoto, Keiko; Ito, Emi; Hamada, Yusuke; Yoshimitsu, Kengo

doi:10.1016/j.radcr.2019.07.020

Cited by 8 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tumor obstruction of the biliary tract may 15,[19][20][21] which occurred in one of our cases. Tumor compression of the pancreatic duct may cause pancreatitis 22 or dilation of the pancreatic duct, 23 and there may be complaints of discomfort due to elevated tumor markers 24 or incidental detection of other diseases during examination. 25,26 The preoperative diagnosis of UCOGCP mainly depends on CT and MRI.…”

Section: Discussionmentioning

confidence: 99%

“…PETCT can provide useful information about the metabolic status of the tumor and the presence or absence of distant metastasis. 23,27,28 ERCP also plays a role in the diagnosis of UCOGCP involving the papilla of duodenum and pancreatic bile duct. Enhanced CT could be used to differentiate UCOGCP from other tumors, such as PDAC or SPT.…”

Section: Discussionmentioning

confidence: 99%

“…The T2-weighted phase of MRI shows low signal and the diffuse-weighted phase shows relatively low or isosignal region. 30 However, due to the influence of common and frequently occurring diseases, UCOGCP may be wrongly diagnosed as pancreatic ductal adenocarcinoma, mucinous cystadenoma, mucinous carcinoma, 31 solid pseudopapillary tumor, 32 neuroendocrine tumor, 23 pancreatic pseudocyst, 33 and other rare types of pancreatic tumors. Tumor markers are of little help to diagnosis.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Undifferentiated Carcinoma of Pancreas with Osteoclast-Like Giant Cells: One Center’s Experience of 13 Cases and Characteristic Pre-Operative Images

Gao¹,

Cai²,

Yin³

et al. 2022

CMAR

View full text Add to dashboard Cite

Background: Undifferentiated carcinoma of pancreas with osteoclast-like giant cells is an extremely rare tumor in pancreas. It is relatively difficult to have preoperative diagnosis due to the lack of specific tumor markers and pre-operative images. Methods: In the present study, database of the pancreas center in the First Affiliated Hospital of Nanjing Medical University was retrospectively screened. A total of thirteen cases diagnosed as undifferentiated carcinoma of pancreas with osteoclast-like giant cells were included. Their clinical data and treatments were collected. Results: Thirteen patients include eight males and five females, and the median age was 67 (60-72) years old. The lesions were found in more than half patients through health examination with no symptoms. NSE was elevated in eight cases (66%). CT scan revealed that cystic and solid lesions often had thick (4/5), contrast-enhanced (5/5) wall with smooth edges (5/5) and the boundary of lesions mainly with solid composition (4/10) is not well demarcated with normal pancreatic parenchyma. All patients received surgical resection. Eight patients had adjuvant chemotherapy and only one patient had adjuvant radiotherapy. The median survival time was 13 months. Five patients had postoperative metastasis or recurrence of tumor and four of them had died of this disease during follow-up. Conclusion: Our data showed that elevated level of NSE and characteristic pre-operative images might provide aid with the preoperative diagnosis for undifferentiated carcinoma of pancreas with osteoclast-like giant cells. Patients with suspected diagnosis should receive surgical intervention as soon as possible, supplemented with postoperative chemotherapy, in order to prolong the survival of patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Undifferentiated Carcinoma of Pancreas with Osteoclast-Like Giant Cells: One Center’s Experience of 13 Cases and Characteristic Pre-Operative Images

Gao¹,

Cai²,

Yin³

et al. 2022

CMAR

View full text Add to dashboard Cite

show abstract

“…The early body of literature regarding these tumors, comprised exclusively of case reports, suggests that they carry a poor prognosis that is even worse than that of undifferentiated pancreatic adenocarcinoma, largely because of late presentation and frequent recurrence after resection 1 . Limited available estimates from these case reports suggest an overall survival (OS) of less than 1 year from time of diagnosis 1,2,4,6,8–11 . However, a more recent study has suggested that OGC of the pancreas may in fact carry a better prognosis that some other subtypes of undifferentiated carcinoma of the pancreas, specifically pleomorphic cell carcinoma.…”

mentioning

confidence: 99%

Osteoclast-Like Giant Cell Tumors of the Pancreas

et al. 2021

View full text Add to dashboard Cite

ObjectivesThis 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.MethodsThis 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.ResultsFifteen 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.ConclusionsOsteoclast-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.

show abstract

“…1 Limited available estimates from these case reports suggest an overall survival (OS) of less than 1 year from time of diagnosis. 1,2,4,6,[8][9][10][11] However, a more recent study has suggested that OGC of the pancreas may in fact carry a better prognosis that some other subtypes of undifferentiated carcinoma of the pancreas, specifically pleomorphic cell carcinoma. The authors also suggest that there is heterogeneity in disease burden at presentation and outcomes within different subtypes of undifferentiated pancreatic carcinoma.…”

mentioning

confidence: 99%

Osteoclast-like giant cell tumors of the pancreas: Clinical characteristics, genetic testing, and treatment modalities.

Ueberroth

Liu

Graham

et al. 2020

JCO

View full text Add to dashboard Cite

e16752 Background: Undifferentiated osteoclast-like giant cell carcinoma of the pancreas is an aggressive malignancy only described by a few case reports in the literature. In this study, we sought to better characterize this entity by examining patients seen at Mayo Clinic. Methods: This study identified patients with osteoclast-like giant cell carcinoma of the pancreas using Mayo Clinic databases (MN, AZ, FL) from the year 2000 to present. Patient demographics, genetic data, and treatment modalities were reviewed. Kaplan-Meier analysis was used to evaluate median overall survival (mOS) for the cohort as well as mOS and mPFS for treatment subgroups. Results: 15 patients were identified (9 female, 6 male). Median age at diagnosis was 59 years and mOS for all patients was 11.0 mos (95% CI 6.2-15.7 mos). 3 patients (20%) had metastatic disease at diagnosis with the liver being the most common site (n = 3). Metastatic disease was associated with significantly shorter OS (3.5 vs. 14.1 mos, p = 0.005; HR 7.98 [95% CI 1.43-44.4]) compared to locoregional disease (LRD). 4 patients underwent genetic testing. The most common mutation was CDKN2A (n = 3), followed by TP53 (n = 2) and KRAS (n = 2). 13/15 patients had detailed follow-up information. 6/7 patients undergoing chemotherapy received a gemcitabine-based regimen as first line: with capecitabine (n = 2), with nab-paclitaxel (n = 2), or as monotherapy (n = 2). 1 patient received FOLFIRINOX. In patients with LRD and adequate follow-up (n = 11), 8/11 underwent surgical resection and had longer OS compared to those without resection (17.0 vs. 8.4 mos, p = 0.09). No surgical patients received neoadjuvant chemotherapy. 5/8 received adjuvant chemotherapy, 2 did not undergo chemotherapy, and 1 was lost to follow-up after surgery. PFS from time of surgery was 15.3mos (95% CI 5.0-25.6mos). 6 patients (40%) were alive at time of analysis; all 6 underwent surgical resection. Conclusions: Osteoclast-like giant cell carcinoma of the pancreas is a rare malignancy with a poor prognosis, even when diagnosed at an early stage. OS for patients of all stages in this study was less than 1 year suggesting prognosis may be even worse than that of pancreatic adenocarcinoma. The optimal therapy remains unknown but most patients received similar chemotherapy as in adenocarcinoma. Patients with LRD amenable to surgical resection experienced a PFS over 1 year from surgery, possibly associated with OS benefit, however overall prognosis is poor. Further study is warranted on a larger scale to better understand disease course and treatment options.

show abstract

Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells showing intraductal growth and intratumoral hemorrhage: MRI features

Cited by 8 publications

References 18 publications

Undifferentiated Carcinoma of Pancreas with Osteoclast-Like Giant Cells: One Center’s Experience of 13 Cases and Characteristic Pre-Operative Images

Undifferentiated Carcinoma of Pancreas with Osteoclast-Like Giant Cells: One Center’s Experience of 13 Cases and Characteristic Pre-Operative Images

Osteoclast-Like Giant Cell Tumors of the Pancreas

Osteoclast-like giant cell tumors of the pancreas: Clinical characteristics, genetic testing, and treatment modalities.

Contact Info

Product

Resources

About