Anaplastic carcinoma of the pancreas derived from an intraductal papillary mucinous neoplasm: a case report.

IF 0.9 Q4 GASTROENTEROLOGY & HEPATOLOGY
Yoko Kawano, Teijiro Hirashita, Hiroki Ichihara, Shota Amano, Hiroomi Takayama, Takashi Masuda, Yuichi Endo, Tsutomu Daa, Masafumi Inomata
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引用次数: 0

Abstract

We report the case of a patient with anaplastic carcinoma of the pancreas derived from an intraductal papillary mucinous neoplasm. A 51-year-old man was reported to have an enlarged cystic lesion in the pancreatic head. Contrast-enhanced computed tomography revealed a multifocal cystic lesion with an internal contrasted nodule. The patient was diagnosed with IPMN with high-risk stigmata and underwent pylorus-preserving pancreaticoduodenectomy. The pathological diagnosis was anaplastic carcinoma of the pancreas, classified as pleomorphic type, derived from intraductal papillary mucinous neoplasm. Based on the morphological features and immunohistochemical reactivity for MUC1, MUC2, MUC5AC, and MUC6, the intraductal papillary mucinous carcinoma was classified as pancreatobiliary type. Immunostaining for tumor-suppressor genes CDKN2A(p16), TP53, SMAD4, and STK11 was performed; aberrant expression of p53, Smad4, and STK11 was observed in intraductal papillary mucinous carcinoma and anaplastic carcinoma. The patient's postoperative course was uneventful; however, para-aortic lymph node metastasis was observed 10 months postoperatively. Immunohistochemical analysis of intraductal papillary mucinous neoplasm subtypes and tumor-suppressor genes may contribute to predicting prognoses in such cases.

胰腺间变性癌源于导管内乳头状粘液瘤:1例报告。
我们报告的病例患者胰腺间变性癌源于导管内乳头状粘液瘤。我们报告一位51岁的男性在胰头有一个增大的囊性病变。增强计算机断层扫描显示多灶性囊性病变及内部对比结节。患者被诊断为IPMN伴高危污头,行保留幽门的胰十二指肠切除术。病理诊断为胰腺间变性癌,分类为多形型,起源于导管内乳头状粘液瘤。根据MUC1、MUC2、MUC5AC和MUC6的形态学特征和免疫组化反应性,将导管内乳头状粘液癌归为胰胆管型。对肿瘤抑制基因CDKN2A(p16)、TP53、SMAD4和STK11进行免疫染色;p53、Smad4和STK11在导管内乳头状粘液癌和间变性癌中表达异常。患者的术后过程平安无事;然而,术后10个月观察到主动脉旁淋巴结转移。导管内乳头状粘液瘤亚型和肿瘤抑制基因的免疫组织化学分析可能有助于预测此类病例的预后。
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来源期刊
Clinical Journal of Gastroenterology
Clinical Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.00
自引率
0.00%
发文量
182
期刊介绍: The journal publishes Case Reports and Clinical Reviews on all aspects of the digestive tract, liver, biliary tract, and pancreas. Critical Case Reports that show originality or have educational implications for diagnosis and treatment are especially encouraged for submission. Personal reviews of clinical gastroenterology are also welcomed. The journal aims for quick publication of such critical Case Reports and Clinical Reviews.
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