Case Report
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World J Gastroenterol. Jan 21, 2014; 20(3): 852-856
Published online Jan 21, 2014. doi: 10.3748/wjg.v20.i3.852
A case report of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct
Mitsuyoshi Okazaki, Isamu Makino, Hirohisa Kitagawa, Shinichi Nakanuma, Hironori Hayashi, Hisatoshi Nakagawara, Tomoharu Miyashita, Hidehiro Tajima, Hiroyuki Takamura, Tetsuo Ohta
Mitsuyoshi Okazaki, Isamu Makino, Hirohisa Kitagawa, Shinichi Nakanuma, Hironori Hayashi, Hisatoshi Nakagawara, Tomoharu Miyashita, Hidehiro Tajima, Hiroyuki Takamura, Tetsuo Ohta, Department of Gastroenterologic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan
Author contributions: Okazaki M and Makino I contributed equally to this work; Okazaki M, Makino I, Kitagawa H, Nakagawara H, Miyashita T, Tajima H, Takamura H and Ohta T performed surgery; Okazaki M and Makino I, Nakanuma S and Hayashi H managed postoperative treatment; Okazaki M and Makino I wrote the paper.
Correspondence to: Mitsuyoshi Okazaki, MD, Department of Gastroenterologic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Japan. mitsuyoshi0610@yahoo.co.jp
Telephone: +81-76-2652362 Fax: +81-76-2344260
Received: August 16, 2013
Revised: October 10, 2013
Accepted: November 1, 2013
Published online: January 21, 2014
Processing time: 187 Days and 0.4 Hours
Abstract

We herein report a case of anaplastic carcinoma of the pancreas with remarkable intraductal tumor growth into the main pancreatic duct. A 76-year-old male was referred to our hospital for treatment of a pancreatic tumor. Preoperative examinations revealed a poorly defined tumor in the main pancreatic duct in the body of the pancreas, accompanied with severe dilatation of the main pancreatic duct, which was diagnosed as an intraductal papillary-mucinous neoplasm. We performed distal pancreatectomy and splenectomy. The pathological examination revealed that the tumor consisted of a mixture of anaplastic carcinoma (giant cell type) and adenocarcinoma in the pancreas. There was a papillary projecting tumor composed of anaplastic carcinoma in the dilated main pancreatic duct. The patient is now receiving chemotherapy because liver metastasis was detected 12 mo after surgery. In this case, we could observe a remarkable intraductal tumor growth into the main pancreatic duct. We also discuss the pathogenesis and characteristics of this rare tumor with specific tumor growth.

Keywords: Anaplastic carcinoma; Giant cell carcinoma; Intraductal tumor growth; Papillary projecting tumor

Core tip: A very rare case of anaplastic carcinoma with remarkable intraductal tumor growth into the main pancreatic duct is reported. This case presented unique features and might help us to better understand the pathogenesis of this rare entity.