Anaplastic Carcinoma of the Pancreas

Chun, Kwang Sik; Song, In Sang

Abstract

Local invasion or distant metastasis is frequently seen in patients with anaplastic carcinoma at the time of presentation, and this is unlike the usual cases of pancreatic carcinoma. So most cases of anaplastic carcinoma are confirmed by autopsy. We report here on our experiences of two cases of the anaplastic pancreatic carcinoma that were confirmed by the postoperative pathology. From January 2006 to December 2006, two patients at Chung-Nam National University Hospital were postoperatively diagnosed as having anaplastic carcinoma of the pancreas. The clinicopathologic data of these patients was reviewed. Case 1) A seventy-years-old male was admitted to our hospital due to his left abdominal pain. On physical examination, there was ill-defined palpable mass on the left upper abdomen. The CA 19-9 level was 4.8 (U/ml). On the abdominal CT scans, a 14.8 cm sized cystic mass with a mild enhancing internal solid portion was detected. He underwent distal pancreatectomy, total gastrectomy and segmental resection of the transverse colon due to direct invasion. The mass was pathologically confirmed as anaplastic pancreatic carcinoma. Postoperatively 3 months later, multiple liver and lymph node metastases were detected on the follow-up CT scan. Case 2) A sixty-five years-old female was referred to our department for a splenic hilar mass that involved the distal pancreas. The CA19-9 level was 3.18 (U/ml). On the preoperative CT scan, an 8.0 cm sized irregular mass with heterogenous contrast enhancement was detected on the tail of the pancreas. She underwent distal pancreatectomy with splenectomy and segmental resection of the transverse colon due to direct invasion. On the pathology report, the pancreatic mass was revealed to be anaplastic carcinoma of the pancreas. One month later, a recurred pancreatic mass and multiple liver and peritoneal metastases were detected on the follow-up CT scan. Anaplastic pancreatic carcinomas show distinctive aggressive behavior and a dismal prognosis.