Anaplastic carcinoma of the pancreas: Case report and literature review of reported cases in Japan

Abstract

We report a case of a 64-year-old woman with anaplastic carcinoma of the pancreas (ACP) with cyst formation and review 60 ACP cases reported in Japan. In 20% of cases, laboratory tests revealed severe anemia (hemoglobin level < 10.0 g/dL) and elevated leucocyte counts (> 12000/mm³), which were likely attributable to rapid tumor growth, intratumoral hemorrhage, and necrosis. Elevated serum CA19-9 levels were observed in 55% of cases. Cyst-like structures were observed on imaging in 47% of cases, and this finding appears to reflect subsequent cystic degeneration in the lesion. Macroscopically, hemorrhagic necrosis was observed in 77% of cases, and cyst formation was observed in 33% of cases. ACP should be considered when diagnosing pancreatic tumors with a cyst-like appearance, especially in the presence of severe anemia, elevated leucocyte counts, or elevated serum CA19-9 levels.

Keywords: Anaplastic carcinoma; Pancreatic cancer; Pleomorphic type; Prognosis; Undifferentiated carcinoma

Core tip: Anaplastic carcinoma of the pancreas (ACP), an uncommon histologic subtype of pancreatic cancer, is well known to be associated with more aggressive tumor behavior and less favorable prognosis than conventional pancreatic ductal adenocarcinoma. However, the literature on ACP has been very limited, and its clinicopathological features, therapeutic management, and clinical outcome remain uncertain. We report a case of ACP showing cyst formation and review 60 cases of ACP reported in Japan to elucidate the clinical and radiological features of ACP. This literature review describes the greatest number cases of ACP of any report to date.