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Chung K, Nawazish A, Chai SM, Bhandari M, Uthamalingam P. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells arising from an intraductal papillary mucinous neoplasm: report of a rare case highlighting diagnostic difficulties. Pathology 2024; 56:594-597. [PMID: 38160096 DOI: 10.1016/j.pathol.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/03/2023] [Accepted: 09/19/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Kimberley Chung
- Department of Anatomical Pathology, PathWest, Fiona Stanley Hospital, Perth, WA, Australia
| | - Arfa Nawazish
- Department of Anatomical Pathology, PathWest, Fiona Stanley Hospital, Perth, WA, Australia
| | - Siaw Ming Chai
- Department of Anatomical Pathology, PathWest, Fiona Stanley Hospital, Perth, WA, Australia
| | - Mayank Bhandari
- Department of Surgery, Fiona Stanley Hospital, Perth, WA, Australia
| | - Preithy Uthamalingam
- Department of Anatomical Pathology, PathWest, Fiona Stanley Hospital, Perth, WA, Australia.
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Mylonakis A, Driva TS, Lykoudis P, Frountzas M, Machairas N, Tsapralis D, Toutouzas KG, Schizas D. Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: An individual participant data meta-analysis. Ann Hepatobiliary Pancreat Surg 2024; 28:125-133. [PMID: 38389117 PMCID: PMC11128790 DOI: 10.14701/ahbps.23-161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGCs) of the pancreas is a rare neoplasm that accounts for less than 1% of all pancreatic malignancies. The aim of this study was to review the literature regarding UC-OGC, and to highlight its biological behavior, clinicopathologic characteristics, prognosis, and therapeutic options. A systematic review of the literature in PubMed/Medline and Scopus databases was performed (last search October 31st, 2023) for articles concerning pancreatic UC-OGC in the adult population. Fifty-seven studies met the inclusion criteria, involving 69 patients with a male-to-female ratio of 1.1:1 and a mean age of 62.96. Main symptoms included abdominal pain (33.3%), jaundice (14.5%), weight loss (8.7%), while fourteen patients (20.3%) were asymptomatic. Surgical resection was performed in 88.4% of cases. Survival rates at one, three, and five years were 58%, 44.7%, and 37.3% respectively. Sex, age, size (cut-off of 4 cm), location, and adjuvant treatment did not significantly affect patient survival. UC-OGC of the pancreas is a rare subtype of undifferentiated pancreatic carcinoma with a better prognosis than conventional pancreatic ductal adenocarcinoma or undifferentiated carcinoma without giant cells. The establishment of a dedicated patient registry is imperative to further delineate the optimal treatment for this uncommon clinical entity.
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Affiliation(s)
- Adam Mylonakis
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Tatiana S. Driva
- First Department of Pathology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Panagis Lykoudis
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Maximos Frountzas
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Nikolaos Machairas
- Second Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | | | - Konstantinos G. Toutouzas
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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Chan W, Park S, Shirkhoda L, O'Connell R, Houshyar R. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells: a case report. J Med Case Rep 2023; 17:477. [PMID: 37968764 PMCID: PMC10652427 DOI: 10.1186/s13256-023-04213-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/12/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Undifferentiated carcinomas of the pancreas with osteoclast-like giant cells (UCPOGC) are rare pancreatic neoplasms that account for less than 1% of all pancreatic malignancies. This case report of a 54-year-old male with metastatic UCPOGC adds to the existing literature and further ascertains the clinical and imaging features, treatment options, and prognosis of this rare entity. CASE PRESENTATION We present the detailed clinical course of a 54-year-old Asian male patient with UCPOGC, with focus on the relevant clinical features and imaging findings that are characteristic of this disease entity. CONCLUSIONS UCPOGC is an extremely rare pancreatic tumor with a unique histopathology and clinical course. It is often difficult to distinguish UCPOGCs from other pancreatic tumors, such as traditional pancreatic ductal adenocarcinomas (PDAC), on imaging, and it therefore remains a pathological diagnosis. Surgery is generally regarded as the first-line treatment option, and the roles of chemotherapy and radiation are unclear. Due to the exceeding rarity of this tumor, large-scale clinical studies are not feasible. Therefore, it is important to share individual insights and experiences to improve our understanding and care for patients with this devastating disease.
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Affiliation(s)
- William Chan
- Irvine Department of Radiological Sciences, University of California, 101 The City Drive South, Orange, CA, 92868, USA
| | - Sungmee Park
- Irvine Department of Radiological Sciences, University of California, 101 The City Drive South, Orange, CA, 92868, USA
| | - Layla Shirkhoda
- Irvine Department of Radiological Sciences, University of California, 101 The City Drive South, Orange, CA, 92868, USA
| | - Ryan O'Connell
- Irvine Department of Pathology and Laboratory Medicine, School of Medicine, University of California, University of California Irvine, Irvine, CA, 92697, USA
| | - Roozbeh Houshyar
- Irvine Department of Radiological Sciences, University of California, 101 The City Drive South, Orange, CA, 92868, USA.
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Imaoka H, Ikeda M, Umemoto K, Sunakawa Y, Ueno M, Ueno H, Ozaka M, Kuwahara T, Okano N, Kanai M, Hisano T, Suzuki Y, Asagi A, Shioji K, Todaka A, Tsuji K, Ikezawa K, Miki I, Komatsu Y, Akutsu N, Yamashita T, Okuyama H, Furuse J, Nagano H. Comprehensive review of undifferentiated carcinoma of the pancreas: from epidemiology to treatment. Jpn J Clin Oncol 2023; 53:764-773. [PMID: 37325968 PMCID: PMC10473279 DOI: 10.1093/jjco/hyad062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 05/27/2023] [Indexed: 06/17/2023] Open
Abstract
Undifferentiated carcinoma (UC) of the pancreas is a rare subtype of pancreatic cancer displaying no definitive direction of differentiation. UC has been reported as a highly aggressive malignant neoplasm, with a median overall survival of <1 year, except for several surgical series. On the other hand, UC tissue sometimes contains non-neoplastic osteoclast-like giant cells (OGCs), and such cases have been reported to have relatively longer survival. Thus, the World Health Organization (WHO) classification histologically distinguishes UC with OGCs (UCOGCs) from UC, and UCs were subclassified into three subtypes: anaplastic UC, sarcomatoid UC and carcinosarcoma. However, still less is known about UC due to its rarity, and such situations lead to further difficulties in treatment for UC. To date, only surgical resection can offer curative treatment for patients with UC, and no clear evidence for chemotherapy exists for them. However, a retrospective cohort study and case reports showed that relatively promising results paclitaxel-containing regimens for treatment of patients with unresectable UC. Furthermore, high programmed cell death protein 1 expression has been reported in sarcomatoid UCs and UCOGCs, and promising responses to anti-programmed death-ligand 1 therapy have been described in case reports of UCOGCs. Recent advances in chemotherapeutic agents and molecular technologies are opening up the possibilities for expanded treatments.
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Affiliation(s)
- Hiroshi Imaoka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masafumi Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kumiko Umemoto
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yu Sunakawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Makoto Ueno
- Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hideki Ueno
- Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masato Ozaka
- Hepato-Biliary-Pancreatic Medicine Department, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takamichi Kuwahara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Naohiro Okano
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Masashi Kanai
- Department of Medical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Terumasa Hisano
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yuko Suzuki
- Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan
| | - Akinori Asagi
- Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Kazuhiko Shioji
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Akiko Todaka
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kunihiro Tsuji
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Kenji Ikezawa
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Ikuya Miki
- Department of Gastroenterological Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Yoshito Komatsu
- Department of Gastroenterology, Hokkaido University Hospital, Sapporo, Japan
| | - Noriyuki Akutsu
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tatsuya Yamashita
- Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan
| | - Hiroyuki Okuyama
- Department of Medical Clinical Oncology, Kagawa University Hospital, MikiKagawa, Japan
| | - Junji Furuse
- Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
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Veron Sanchez A, Santamaria Guinea N, Cayon Somacarrera S, Bennouna I, Pezzullo M, Bali MA. Rare Solid Pancreatic Lesions on Cross-Sectional Imaging. Diagnostics (Basel) 2023; 13:2719. [PMID: 37627978 PMCID: PMC10453474 DOI: 10.3390/diagnostics13162719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Several solid lesions can be found within the pancreas mainly arising from the exocrine and endocrine pancreatic tissue. Among all pancreatic malignancies, the most common subtype is pancreatic ductal adenocarcinoma (PDAC), to a point that pancreatic cancer and PDAC are used interchangeably. But, in addition to PDAC, and to the other most common and well-known solid lesions, either related to benign conditions, such as pancreatitis, or not so benign, such as pancreatic neuroendocrine neoplasms (pNENs), there are solid pancreatic lesions considered rare due to their low incidence. These lesions may originate from a cell line with a differentiation other than exocrine/endocrine, such as from the nerve sheath as for pancreatic schwannoma or from mesenchymal cells as for solitary fibrous tumour. These rare solid pancreatic lesions may show a behaviour that ranges in a benign to highly aggressive malignant spectrum. This review includes cases of an intrapancreatic accessory spleen, pancreatic tuberculosis, solid serous cystadenoma, solid pseudopapillary tumour, pancreatic schwannoma, purely intraductal neuroendocrine tumour, pancreatic fibrous solitary tumour, acinar cell carcinoma, undifferentiated carcinoma with osteoclastic-like giant cells, adenosquamous carcinoma, colloid carcinoma of the pancreas, primary leiomyosarcoma of the pancreas, primary and secondary pancreatic lymphoma and metastases within the pancreas. Therefore, it is important to determine the correct diagnosis to ensure optimal patient management. Because of their rarity, their existence is less well known and, when depicted, in most cases incidentally, the correct diagnosis remains challenging. However, there are some typical imaging features present on cross-sectional imaging modalities that, taken into account with the clinical and biological context, contribute substantially to achieve the correct diagnosis.
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Affiliation(s)
- Ana Veron Sanchez
- Hôpital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium; (I.B.)
| | | | | | - Ilias Bennouna
- Hôpital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium; (I.B.)
| | - Martina Pezzullo
- Hôpital Universitaire de Bruxelles, Hôpital Erasme, 1070 Brussels, Belgium
| | - Maria Antonietta Bali
- Hôpital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium; (I.B.)
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Ran H, Chen G, He Y, Yu Q, Xie Y, Liu J, Liu H, Zhang T. Undifferentiated carcinoma with osteoclast‑like giant cells of the pancreas: A case report. Oncol Lett 2023; 25:252. [PMID: 37153037 PMCID: PMC10161351 DOI: 10.3892/ol.2023.13838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/31/2023] [Indexed: 05/09/2023] Open
Abstract
Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas (UCOGCP) is a rare pancreatic tumor that accounts for <1% of all primary pancreatic malignant tumors. Although the tumor is considered a variant of pancreatic ductal adenocarcinoma, there are substantial differences in the clinicopathological characteristics between UCOGCP and pancreatic ductal adenocarcinoma. Imaging examinations are useful in making a correct diagnosis, and providing a reasonable and effective surgical treatment regimen; however, the imaging characteristics of UCOGCP require further investigation. The present report describes a rare case of UCOGCP with rapid progression and poor prognosis. The patient could not undergo surgery and received chemotherapy drugs only. Chemotherapy did not markedly improve the outcome, and a follow-up 6 months after discharge showed that the patient had died. The present report describes this case and summarizes the available imaging findings to increase awareness, and to improve early diagnosis of this rare disease and therapeutic outcomes.
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Affiliation(s)
- Haifeng Ran
- Department of Radiology, Medical Imaging Center of Guizhou Province, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Guiqin Chen
- Department of Radiology, Medical Imaging Center of Guizhou Province, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Yulun He
- Department of Radiology, Medical Imaging Center of Guizhou Province, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Qiane Yu
- Department of Radiology, Medical Imaging Center of Guizhou Province, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Yuxin Xie
- Department of Radiology, Medical Imaging Center of Guizhou Province, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Junwei Liu
- Department of Radiology, Medical Imaging Center of Guizhou Province, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Heng Liu
- Department of Radiology, Medical Imaging Center of Guizhou Province, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
- Correspondence to: Professor Tijiang Zhang or Professor Heng Liu, Department of Radiology, Medical Imaging Center of Guizhou Province, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan, Zunyi, Guizhou 563000, P.R. China, E-mail:
| | - Tijiang Zhang
- Department of Radiology, Medical Imaging Center of Guizhou Province, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
- Correspondence to: Professor Tijiang Zhang or Professor Heng Liu, Department of Radiology, Medical Imaging Center of Guizhou Province, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan, Zunyi, Guizhou 563000, P.R. China, E-mail:
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Undifferentiated Carcinoma With Osteoclast-Like Giant Cells: A Rare Cause of Upper Gastrointestinal Bleeding. ACG Case Rep J 2023; 10:e00975. [PMID: 36713281 PMCID: PMC9875979 DOI: 10.14309/crj.0000000000000975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/04/2023] [Indexed: 01/31/2023] Open
Abstract
Undifferentiated osteoclast-like giant cell carcinomas (UOLGCCs) of the digestive tract are very rare, with only a few cases reported in the literature. An 82-year-old man was referred to the emergency department for melena. Endoscopic examination revealed a hemicircumferential ulcerovegetative lesion, involving the bulbar apex and extending to the second portion of the duodenum; biopsies revealed an UOLGCC. The patient underwent transfusion support therapy, and he was proposed for best supportive care. Duodenal UOLGCC is an extremely rare cause of upper gastrointestinal bleeding. Clinical findings and therapeutic approach represent a challenge in this pathology.
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Swaid MB, Vitale E, Alatassi N, Siddiqui H, Yazdani H. Metastatic Undifferentiated Osteoclast-Like Giant Cell Pancreatic Carcinoma. Cureus 2022; 14:e27586. [PMID: 36059324 PMCID: PMC9433786 DOI: 10.7759/cureus.27586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 11/19/2022] Open
Abstract
Undifferentiated osteoclast-like giant cell pancreatic carcinoma (UC-OGC) is a rare pancreatic carcinoma that is composed of osteoclast-like giant cells among other cells and is hardly described in literature due to its infrequent presentation. With that, a rare symptom of pancreatic cancers is upper gastrointestinal (GI) bleeding. We report a 76-year-old African American male who presented with one episode of bloody emesis associated with intermittent episodes of severe abdominal pain and a 25 lbs of unintentional weight loss secondary to metastatic UC-OGC. The patient was stabilized and referred to an oncologist for further treatment. We present this case to add to the existing literature on UC-OGC of the pancreas.
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Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas mimicking pancreatic pseudocyst. Hepatobiliary Pancreat Dis Int 2022; 21:403-405. [PMID: 35792012 DOI: 10.1016/j.hbpd.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 06/21/2022] [Indexed: 02/05/2023]
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Wang X, Miao J, Wang S, Shen R, Zhang S, Tian Y, Li M, Zhu D, Yao A, Bao W, Zhang Q, Tang X, Wang X, Li J. Single-cell RNA-seq reveals the genesis and heterogeneity of tumor microenvironment in pancreatic undifferentiated carcinoma with osteoclast-like giant-cells. Mol Cancer 2022; 21:133. [PMID: 35733218 PMCID: PMC9214989 DOI: 10.1186/s12943-022-01596-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/15/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Undifferentiated carcinoma with osteoclast-like giant cells (OGCs) of pancreas (UCOGCP) is a rare subtype of pancreatic ductal adenocarcinoma (PDAC), which had poorly described histopathological and clinical features. METHODS In this study, single-cell RNA sequencing (scRNA-seq) was used to profile the distinct tumor microenvironment of UCOGCP using samples obtained from one UCOGCP patient and three PDAC patients. Bioinformatic analysis was carried out and immunohistochemical (IHC) staining was used to support the findings of bioinformatic analysis. After quality control of the raw data, a total of 18,376 cells were obtained from these four samples for subsequent analysis. These cells were divided into ten main cell types following the Seurat analysis pipeline. Among them, the UCOGCP sample displayed distinct distribution patterns from the rest samples in the epithelial cell, myeloid cell, fibroblast, and endothelial cell clusters. Further analysis supported that the OGCs were generated from stem-cell-like mesenchymal epithelial cells (SMECs). RESULTS Functional analysis showed that the OGCs cluster was enriched in antigen presentation, immune response, and stem cell differentiation. Gene markers such as LOX, SPERINE1, CD44, and TGFBI were highly expressed in this SMECs cluster which signified poor prognosis. Interestingly, in myeloid cell, fibroblasts, and endothelial cell clusters, UCOGCP contained higher percentage of these cells and unique subclusters, compared with the rest of PDAC samples. CONCLUSIONS Analysis of cell communication depicted that CD74 plays important roles in the formation of the microenvironment of UCOGCP. Our findings illustrated the genesis and function of OGCs, and the tumor microenvironment (TME) of UCOGCP, providing insights for prognosis and treatment strategy for this rare type of pancreatic cancer.
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Affiliation(s)
- Xinbo Wang
- Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu, China
| | - Jiaying Miao
- International Genome Center, Jiangsu University, Zhenjiang, 212013 Jiangsu China
| | - Sizhen Wang
- Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu, China
| | - Rongxi Shen
- Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu, China
| | - Shuo Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, NJU Advanced Institute for Life Sciences (NAILS), Nanjing University, 163 Xianlin Road, Nanjing, 210046 Jiangsu China
| | - Yurao Tian
- Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu, China
| | - Min Li
- Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu, China
| | - Daojun Zhu
- Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu, China
| | - Anlong Yao
- Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu, China
| | - Wei Bao
- Department of Pathology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu China
| | - Qun Zhang
- Department of Medical Oncology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu China
| | - Xingming Tang
- Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu, China
| | - Xingyun Wang
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieshou Li
- Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002 Jiangsu, China
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Undifferentiated Carcinoma with Osteoclast-Like Giant Cells of the Common Bile Duct: A Case Report of a Rare Entity at an Unusual Location. Diagnostics (Basel) 2022; 12:diagnostics12071517. [PMID: 35885423 PMCID: PMC9324465 DOI: 10.3390/diagnostics12071517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022] Open
Abstract
Undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) is a rare variant of carcinoma with unique radiological and pathological features. This unusual carcinoma has been reported in a variety of organs and pancreas is the most frequently involved anatomical site. UCOGC of pancreas attains a relatively indolent clinical behavior and should be distinguished from ordinary pancreatobiliary adenocarcinoma. This paper presents the first case of UCOGC involving the entire segment of common bile duct (CBD) and common hepatic duct (CHD) without extending to the pancreatic tissue. Getting familiar with its clinical, radiological and pathological characters can help establish accurate diagnosis despite the occurrence of an unusual location.
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12
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Igarashi Y, Gocho T, Taniai T, Uwagawa T, Hamura R, Shirai Y, Yasuda J, Haruki K, Furukawa K, Ikegami T. Conversion surgery for undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a case report. Surg Case Rep 2022; 8:42. [PMID: 35286506 PMCID: PMC8921425 DOI: 10.1186/s40792-022-01385-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background Undifferentiated carcinoma with osteoclast-like giant cells (UCOGCs) is a rare subtype of pancreatic cancer (PC), and its clinicopathological characteristics are still unclear. Herein, we report a case of initially unresectable UCOGC that was successfully resected after FOLFIRINOX therapy. Case presentation A 63-year-old man was referred to us for evaluation of a pancreatic mass detected by computed tomography (CT) during a medical checkup. Computed tomography showed a 7.5-cm tumor located in the pancreatic head and body, which involved the common hepatic artery (CHA), gastroduodenal artery (GDA), and main portal vein (PV) with tumor thrombus. UCOGC was suspected by endoscopic ultrasonography-guided fine needle aspiration, and the patient was diagnosed with unresectable locally advanced pancreatic cancer. After ten cycles of FOLFIRINOX, the tumor size decreased to 3 cm and the tumor thrombus in the main portal trunk had disappeared in the follow-up CT scan. However, the patient experienced severe adverse drug reactions, including neutropenia and liver dysfunction. Therefore, we performed pancreatoduodenectomy with portal vein resection. The pathological diagnosis was UCOGC with a negative tumor margin. He was treated with FOLFIRINOX, and remains recurrence-free for 6 months after surgery. Conclusions We experienced a case undergoing conversion surgery for unresectable UCOGC, which resulted in R0 resection. FOLFIRINOX could be a possible regimen to achieve conversion surgery for UCOGC.
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Affiliation(s)
- Yosuke Igarashi
- Division of Hepatobiliary and Pancreas, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Takeshi Gocho
- Division of Hepatobiliary and Pancreas, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Tomohiko Taniai
- Division of Hepatobiliary and Pancreas, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Tadashi Uwagawa
- Division of Hepatobiliary and Pancreas, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryoga Hamura
- Division of Hepatobiliary and Pancreas, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshihiro Shirai
- Division of Hepatobiliary and Pancreas, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Jungo Yasuda
- Division of Hepatobiliary and Pancreas, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Koichiro Haruki
- Division of Hepatobiliary and Pancreas, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenei Furukawa
- Division of Hepatobiliary and Pancreas, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Toru Ikegami
- Division of Hepatobiliary and Pancreas, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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