Korean J Gastroenterol.  2024 Sep;84(3):128-131. 10.4166/kjg.2024.059.

Case of Undifferentiated Carcinoma with Osteoclast-like Giant Cells Associated with a Mucinous Cystic Neoplasm of the Pancreas: A Diagnostic Conundrum

• Kapatia G
• Jindal A
• Kaushal G
• Soni A
• Rana MK

• KMID: 2559846
• DOI: http://doi.org/10.4166/kjg.2024.059

Abstract

Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGC) is a rare histological subtype of pancreatic ductal adenocarcinoma according to the World Health Organization classification of digestive system tumors. This subtype is exceptionally uncommon, accounting for less than 1% of pancreatic malignant tumors. This paper presents a rare case of a 62-year-old female patient diagnosed with UC-OGC. The patient initially presented with symptoms, including epigastric pain and the presence of an abdominal mass, which led to further investigation and the eventual diagnosis of this unusual and challenging form of pancreatic cancer.

Keyword

Histopathology; Malignant neoplasm; Pancreas

Figure

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  Fig. 1 (A) Gross image showing a circumscribed tumor with solid and cystic components. A focal area (black solid arrow) shows a yellowish mural nodule. Normal pancreatic parenchyma can be seen at the periphery of the tumor (red solid arrow). (B) Low power view showing different components of UC-OGC: multinucleated giant cells with interspersed mononuclear stromal cells (black solid arrow), osteoid (orange solid arrow) associated with a neoplastic epithelial component with a mucinous lining (green solid arrow) (H&E stain, 40x). (C) Low power view showing multinucleated osteoclast-like giant cells with interspersed mononuclear stromal cells (H&E stain, 100x). (D) High power view showing multinucleated osteoclast-like giant cells (black solid arrow) with interspersed mononuclear stromal cells and tumor giant cells (H&E stain, 100x). (E) Low power view showing neoplastic epithelial component with a mucinous lining (H&E stain, 40x). (F) Low power view showing a neoplastic epithelial component with a mucinous lining exhibiting dysplastic features (H&E stain, 100x).

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  Fig. 2 (A) CD68. (B, C) Vimentin highlighted multinucleated giant cells (IHC, 200x) that were negative for CD45 (IHC, 200x).

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