Undifferentiated carcinoma with osteoclast-like giant cells: A pathologic-radiologic correlation of a rare histologic subtype of pancreatic ductal adenocarcinoma

2022 ◽  
pp. 151884
Author(s):  
Pragya Virendrakumar Jain ◽  
Michael Griffin ◽  
Bryan Hunt ◽  
Erin Ward ◽  
Susan Tsai ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Giant Cells ◽  
Undifferentiated Carcinoma ◽  
Ductal Adenocarcinoma ◽  
Histologic Subtype

scholarly journals Durable Response to PD-1 Blockade in a Patient With Metastatic Pancreatic Undifferentiated Carcinoma With Osteoclast-Like Giant Cells

2021 ◽  
Vol 19 (3) ◽  
pp. 247-252
Author(s):  
Robert J. Besaw ◽  
Adrienne R. Terra ◽  
Grace L. Malvar ◽  
Tobias R. Chapman ◽  
Lauren M. Hertan ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Giant Cells ◽  
Undifferentiated Carcinoma ◽  
Ductal Adenocarcinoma ◽  
Next Generation ◽  
Durable Response ◽  
Tumor Mutation Burden ◽  
Mutation Burden ◽  
Generation Sequencing

Undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) of the pancreas is a rare and potentially aggressive variant of pancreatic ductal adenocarcinoma. Data on this disease are sparse, and despite genetic similarities to pancreatic ductal adenocarcinoma, UCOGC clinical outcomes can be markedly different. We report on a female patient aged 62 years who presented with UCOGC with pulmonary metastases initially treated with 2 lines of cytotoxic chemotherapy. After rapid disease progression with both cytotoxic treatments, the patient’s tissue was sent for next-generation sequencing, which revealed a high tumor mutation burden (32 mutations per megabase), as well as somatic mutations in BRAF, NF1, PIK3CA, CDKN2A, TERT, and TP53. Pancreatic cancers have previously demonstrated suboptimal responses to immunotherapeutic approaches. However, given the high tumor mutation burden and distinctiveness of the tumor class, the patient began third-line pembrolizumab monotherapy after palliative radiation to the rapidly progressing and painful abdominal mass from her primary tumor. She had a marked response in her primary UCOGC tumor and metastatic sites, and she remains on pembrolizumab monotherapy with ongoing response after 32 months of therapy. Recent evidence showing significant PD-L1 enrichment on neoplastic cells of undifferentiated carcinomas (including UCOGC) may indicate a role for immunotherapeutic approaches in these patients. Rare cancers such as UCOGC and other undifferentiated carcinomas may benefit from next-generation sequencing to inform treatment decisions when standards of care are absent, as in this report.

scholarly journals Undifferentiated carcinoma with osteoclastic giant cells of pancreas: Case report and brief literature review

2021 ◽  
Vol 6 (4) ◽  
pp. 307-310
Author(s):  
Jyoti Parag Dekate ◽  
Manjula V Kelkeri ◽  
Gowri Garudadri
Keyword(s):  
Literature Review ◽  
Giant Cells ◽  
Genetic Alterations ◽  
Undifferentiated Carcinoma ◽  
Survival Period ◽  
Prolonged Survival ◽  
Ductal Adenocarcinoma ◽  
Genetic Profile ◽  
Rare Neoplasm ◽  
Pathologic Features

Undifferentiated carcinoma with osteoclastic giant cells is a distinctive rare neoplasm involving pancreas and rarely bile ducts. This neoplasm shows characteristic histologic features with variable admixture of mononuclear histiocytic cells, non- neoplastic osteoclastic giant cells and neoplastic mononuclear cell component. Though, this tumor has been shown to share genetic alterations with pancreatic ductal adenocarcinoma, clinically, it behaves unpredictably with a substantial proportion of patient showing prolonged survival period. We present a case of this rare pancreatic tumour with brief literature review discussing the key pathologic features, immunophenotype, genetic profile and clinical behavior. Undifferentiated carcinoma with osteoclastic giant cells is a rare neoplasm in pancreas which is believed to be of epithelial origin and shares genetic aberrations with ductal adenocarcinoma. Despite this, these tumours have better prognosis with prolonged survival period.

scholarly journals Pancreatic undifferentiated carcinoma with osteoclast-like giant cells is genetically similar to, but clinically distinct from, conventional ductal adenocarcinoma

2017 ◽  
Vol 243 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Claudio Luchini ◽  
Antonio Pea ◽  
Gemma Lionheart ◽  
Andrea Mafficini ◽  
Alessia Nottegar ◽  
...  
Keyword(s):  
Giant Cells ◽  
Undifferentiated Carcinoma ◽  
Ductal Adenocarcinoma

scholarly journals Prognostic Factors in Resected Pancreatic Ductal Adenocarcinoma: Is Neutrophil-Lymphocyte Ratio a Useful Marker?

2021 ◽  
Author(s):  
Ignacio Guillermo Merlo ◽  
Victoria Ardiles ◽  
Rodrigo Sanchez-Clariá ◽  
Eugenia Fratantoni ◽  
Eduardo de Santibañes ◽  
...  
Keyword(s):  
Overall Survival ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Adjuvant Treatment ◽  
Tumor Size ◽  
Pancreatic Resection ◽  
Perineural Invasion ◽  
Undifferentiated Carcinoma ◽  
Ductal Adenocarcinoma ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract Background: The aim of this study is to analyze the role of neutrophil-lymphocyte ratio and its variation pre and post-operatively (delta NLR) in overall survival after pancreatectomy for pancreatic ductal adenocarcinoma at a single centre and to identify factors associated with overall survival.Methods: A retrospective study of consecutive patients undergoing pancreatic resection due to PDAC or undifferentiated carcinoma from January 2010 to January 2020 was performed. Association between evaluated factors and overall survival were analyzed using a log-rank test and Cox proportional hazard regression model.Results: Overall, 242 patients underwent complete pancreatic resection for PDAC or undifferentiated carcinoma. OS was 22.8 months (95% CI: 19.5-29) and survival rates at 1, 3 and 5 years were 72%, 32.5% and 20.8% respectively. NLR and delta NLR were not significantly associated with survival (HR=1.14, 95%CI: 0.77-1.68, p=0.5). Lymph node ratio was significantly associated (HR=1.66, 95%CI: 1.21-2.26, p=0.001) in the bivariate analysis. In multivariable analysis the only factors that were significantly associated with survival were perineural invasion (HR=1.94, 95%CI: 1.21-3.14, p=0.006), surgical margin (HR=1.83, 95%CI: 1.10-3.02, p=0.019), tumor size (HR=1.01, 95%CI: 1.003-1.027, p=0.16), postoperative CA 19-9 level (HR=1.001, p<0.001), and completion of adjuvant treatment (HR=0.53, 95%CI: 0.35-0.8, p=0.002).Conclusion: Neutrophil-lymphocyte ratio and delta NLR were not associated with overall survival in this cohort. Risk factors such as perineural invasion, surgical margins, CA19-9 level and tumor size showed worse survival in this study, whereas completing adjuvant treatment was a protective factor.

Clinical significance of cathepsin E in pancreatic juice in the diagnosis of pancreatic ductal adenocarcinoma

2000 ◽  
Vol 15 (11) ◽  
pp. 1333-1338 ◽  
Author(s):  
Koji Uno ◽  
Takeshi Azuma ◽  
Masatsugu Nakajima ◽  
Kenjiro Yasuda ◽  
Takanobu Hayakumo ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Clinical Significance ◽  
Pancreatic Juice ◽  
Ductal Adenocarcinoma ◽  
Cathepsin E

The role of insulin receptor and insulin-like growth factor I receptor in pancreatic ductal adenocarcinoma

2013 ◽  
Vol 51 (08) ◽  
Author(s):  
E Kalideris ◽  
B Grüner ◽  
M Trajkovic-Arsic ◽  
P Mazur ◽  
RM Schmid ◽  
...  
Keyword(s):  
Growth Factor ◽  
Insulin Receptor ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Ductal Adenocarcinoma ◽  
Insulin Like Growth Factor ◽  
Factor I ◽  
Growth Factor I
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