Abstract
A 76-year-old female case with undifferentiated pancreatic carcinoma was reported, which showed cystic like lesion by imaging diagnosis, and the review of the report cases for 10-years in Japan was added up. She was admitted to our hospital because of further examination of epigastric discomfort. US showed a well defined tumor with hyperechoic capsule, in which was hypoechoic area. CT scan revealed an encapsulated mass with heterogenous density. Localized marked dilatation of the main duct was seen by endoscopic pancreatography. Angiography showed many tumor vessels in margin of the tumor. These findings were compatible with cystic neoplasma of the pancreas such as cystadenocarcinoma and mucin producing pancreatic tumor. Distal pancreatectomy was performed. Macroscopically, the tumor was mainly encapsulated with fibrous tissue containing necrotic tissue in pancreas. Histologically, fibrous capsule was composed of undifferentiated carcinoma cells. Immunohistochemical staining for EMA showed positive but negative staining by LCA, NSE, and Vimentin. Thirty seven patients with undifferentiated carcinoma in Japan were reported with reference to the characteristics of clinical features. Elevation in serum CEA level was not observed in eleven of twelve patients. The average of the survival period after detection of the pancreas tumor was about 5.5 months with poor prognosis. The morphological features were discussed in these cases.
