A Case of Pancreatic Cancer Including Osteoclast-like Gaiant Cells

Hirotaka Iwase*, Yasuyuki Kureyama*, Masanobu Kiriyama*, Yukashi Ito*, Yoshiyuki Furuta**

Department of Surgery, Central Hospital
*Present adress: Second Department of Surgery, Nagoya City University
**Present adress: Furuta Surgical Clinic

A rare case of pancreas cancer with osteoclast-like giant cells is reported. A 54-year-old man with epigastralgia and jandice was diagnosed by endoscopic retrograde cholangiopancreatography as having intra- and extrahepatic choleithiasis. Laparotomy revealed a hard tumor invading the hepatoumbilical ligamentum and neck of the gall bladder. The choledochus was packed with coagula. A cholecystectomy with drainage of the choledochus was carried out. The adenocarcinoma with osteoclast-like giant cells was diagnosed by a intraoperative histological examination of the invasive tumor portion. The patient died 1 month after the operation due to hepatic falire. A hen's egg-sized tumor was found in the head of the pancreas at autopsy. Generally, adenocarcinoma of the pancreas with osteoclastic giant cells been distinguished from the pleomorphic type. They have been reported to be highly locally invasive. The histogenesis of giant cells observed in this kind of tumor has been controversial. However, recent repots using electron microscopic or immunohistochemical investigations suggested an acinar cell origin of these giant cells rather than histiocytic cells, in spite of their osteoclast-like appearance.

Key words
pancreatic cancer, osteoclast-like giant cell tumor

Reprint requests
Hirotaka Iwase Second Department of Surgery, Nagoya City University Medical School
1 Kawasmi, Mizuho-cho, Mizuho-ku, Nagoya, 467 JAPAN

Accepted
December 13, 1989

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