Abstract
A 71–year–old man admitted for epigastralgia and tarry stool whose laboratory tests on admission showed only anemia was found in abdominal computed tomography (CT) to have an unevenly light–enhanced duodenal mass 5×4.5 cm in diameter. Upper gastrointestinal endoscopy showed an elevated soft 5 cm lesion. Magnetic resonance imaging (MRI) showed an elevated duodenal lesion apparently unrelated to the papilla of Vater or pancreas. Pancreatic and bile ducts were normal. Upper gastrointestinal endoscopic biopsy showed undifferentiated carcinoma with osteoclastoid giant cells. The man underwent pylorus–preserving pancreatoduodenectomy. Pathological examination showed giant cell osteoclastoid carcinoma of the pancreas. Multiple liver metastases observed 4 months after surgery were treated with hepatic infusional 5Fu chemotherapy. As of October 2008, he is living under ongoing treatment.
