A Long Surviving Case with Undifferentiated Pancreatic Carcinoma.

A 70-year-old man presented with abdominal pain. Enhanced CT revealed a hypodense mass with peripheral enhancement in the pancreatic body (Picture 1). Endoscopic ultrasonography confirmed a well-defined hypoechoic mass measuring 20 mm in size (Picture 2). Endoscopic retrograde pancreatography showed a smooth narrowing of the pancreatic duct with displacement (Picture 3). Surgical resection was performed. The resected specimen measured 20×18 mm in size with a thick fibroid capsule. The histopathological results confirmed it to be undifferentiated carcinoma, with osteoclast-like giant cells (UCOGC) and no vascular invasion (Picture 4). There had been no further recurrence for over five years following surgery.

Picture 1.

Picture 2.

Picture 3.

Picture 4.

UCOGC is a rare pancreatic malignancy that has been reported to have a more favorable prognosis than pancreatic ductal adenocarcinoma (1). The good outcome in such patients might be attributable to following factors. The presence of osteoclast-like giant cells has been associated with an improved prognosis (2). In addition, the small tumor size and encapsulation may increase the survival period for such cases.