2022 Volume 37 Issue 2 Pages 104-111
The patient is a female in her 70s referred for further workup after dilatation of the main pancreatic duct was seen on abdominal ultrasonography performed to evaluate cardiac orbital pain. Contrast-enhanced computed tomography scan showed an approximately 15mm contrast-enhancing mass in the pancreatic head. EUS-FNA was performed and revealed spindle-shaped cells, pleomorphic cells of unequal size, and atypical cells with osteoclast-like giant cells. These atypical cells were CD68 (KP-1) positive by immunostaining and diagnosed as anaplastic carcinoma of the pancreatic head. Pylorus preserving pancreaticoduodenectomy was performed. Histopathologic examination of the surgical specimen showed mainly pleomorphic cells, but also spindle-shaped cells and osteoclast-like giant cells, leading to the diagnosis of pT1c pleomorphic cell type anaplastic carcinoma TS1. The patient is currently alive and recurrence-free 9 months after resection. This patient had anaplastic carcinoma TS1 definitively diagnosed by preoperative EUS-FNA and resected.
