2017 Volume 32 Issue 5 Pages 812-820
Contrast-enhanced CT of a 49-year-old woman with back pain revealed a low-density tumor in the pancreas head and multifocal liver metastases. Endoscopic ultrasonography-guided fine needle aspiration of the tumor led to the diagnosis of anaplastic carcinoma of the pancreas. The patient was referred to our hospital for chemotherapy. A combination therapy with 80% doses of gemcitabine and nab-paclitaxel was administered. Follow-up CT after the chemotherapy showed slight reduction of the primary pancreatic tumor and remarkable reduction of liver metastases. Three months after introduction of the chemotherapy, however, the combination therapy had to be changed to monotherapy with S-1 due to appetite loss and decreasing activity of daily living. The patient died four months after the first visit due to general prostration. Autopsy revealed pleomorphic anaplastic carcinoma of the pancreas. Pleomorphic anaplastic pancreas carcinoma is a rare and highly virulent condition, and above all, there have been almost no reported cases that have showed any response to chemotherapy. The partial response described in this report would be instructive in deciding treatment strategy for unresectable pleomorphic anaplastic carcinoma of the pancreas.
