A case of anaplastic ductal carcinoma of the pancreas

Abstract

We report a case of anaplastic ductal carcinoma of the pancreatic head. A 64-year-old woman was admitted to our hospital complaining of epigastralgia ; she had obstructive jaundice and liver dysfunction. On upper gastrointestinal endoscopy, a tumor at the opposite side of Vater's pappilla located in the second portion of the duodenum was found. On laboratory testing, increased serum CEA and CA19-9 levels were noted. Ultrasonography and CT showed a solid mass measuring 32×23 mm in diameter located in the head of the pancreas. Contrast-enhanced CT and MRI revealed nonhomogenous mass. Based on these clinical findings, a resection was performed under a diagnosis of cancer of the duodenal papilla. The resected tumor appeared to be focally expanding ; lymphnode metastases were present. On histology, an anaplastic ductal carcinoma of the giant cell type that was characterized by a non-cohesive, sarcoma-like growth pattern, and the presence of bizarre mono-and multi-nucleated giant cells was found. The patient died of renal failure 29 months after the operation.