A Case of Anaplastic Carcinoma of the Pancreas (Spindle Cell Type)

Yoshitsugu Nakanishi¹⁾³⁾, Masafumi Sato¹⁾, Masaya Kawada¹⁾³⁾, Hiroshi Gyoubu¹⁾³⁾, Hiroyuki Hisai²⁾, Kumiko Tateno²⁾, Ken Ikeda⁴⁾, Tomoo Itoh⁵⁾, Toshiaki Morikawa³⁾ and Satoshi Kondo³⁾

Department of Surgery¹⁾ and Department of Gastroenterology²⁾, Japan Red Cross Date General Hospital
Department of Surgical Oncology, Hokkaido University Graduate School of Medicine³⁾
Department of Surgical Pathology, Sapporo Medical University Hospital⁴⁾
Department of Surgical Pathology, Hokkaido University Hospital⁵⁾

A 69-year-old man referred for upper abdominal pain and back pain was found in ultrasonography (US) to have a low echoic mass 1.6 cm in diameter with hyperechoic spots inside the pancreatic body. Enhanced US showed a hypervascular tumor. Abdominal computer tomography (CT) showed a mass enhanced on the pancreatic body. Biopsy from the tumor revealed adenocarcinoma diagnosed as carcinoma of the pancreas necessitating distal pancreatectomy with splenectomy. Histological studies showed a tumor 1.5 cm in diameter consisting of tubular adenocarcinoma and spindle cells. The definitive diagnosis was anaplastic spindle-cell carcinoma of the pancreas. Five months after the operation, recurrence was found in the left abdominal field and 1 month after that, a tumor was found at the ampulla of Vater. Biopsy from the tumor at the ampulla of Vater showed sarcomatous components. Liver metastasis also occurred, and the man died 8 months after the operation.

Key words
anaplastic carcinoma of the pancreas, spindle cell type

Reprint requests
Yoshitsugu Nakanishi Department of Surgical Oncology, Cancer Medicine, Division of Cancer Medicine, Hokkaido University
Kita-15, Nishi-7, Kita-Ku, Sapporo, 060-8638 JAPAN

Accepted
December 16, 2005

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