Multifocal Anaplastic Pancreatic Carcinoma Requiring Neoadjuvant Chemotherapy and Total Pancreatectomy: Report of a Case

  • Teresa S Jones Section of GI, Tumor and Endocrine Surgery, Department of Surgery, University of Colorado at Denver. Aurora, CO, USA
  • Edward L Jones Section of GI, Tumor and Endocrine Surgery, Department of Surgery, University of Colorado at Denver. Aurora, CO, USA
  • Martine McManus Division of Gastrointestinal Pathology, Department of Pathology, University of Colorado at Denver. Aurora, CO, USA
  • Raj Shah Division of Gastroenterology and Hepatology, Department of Medicine, University of Colorado at Denver. Aurora, CO, USA
  • Csaba Gajdos Section of GI, Tumor and Endocrine Surgery, Department of Surgery, University of Colorado at Denver. Aurora, CO, USA
Keywords: Carcinoma, Neoadjuvant Therapy, Pancreatic Neoplasms

Abstract

Context Anaplastic pancreatic carcinoma is a rare tumor with poor survival. Data on surgical and medical therapies are currently limited to case reports and case series with small numbers. Case report We describe a case of multifocal anaplastic pancreatic carcinoma treated with neoadjuvant FOLFIRINOX (oxaliplatin, irinotecan, fluorouracil and leucovorin) and total pancreatectomy with subsequent patient disease-free survival currently at 12 months. Discussion The goal for anaplastic pancreatic carcinoma treatment should continue to be complete surgical resection. Optimum chemotherapeutic options continue to be investigated.

Image: Foreign body giant cells.

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References

Hamilton SR, Aaltonen LA eds. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive system. Lyon: IARC Press 2000; 221–230.

Paal E, Thompson DL, Frommelt RA, Przygodzki RM, Heffess CS. A Clinicopathologic and Immunohistochemical study of 35 Anaplastic Carcinomas of the Pancreas with Review of the Literature. Annals of Diagn Pathol. 2001 Jun 5(3):129-140.

Chadha MK, LeVea C, Javle M, Kuvshinoff B, Vijaykumar R, Iyer R. Anaplastic Pancreatic Carcinoma. A Case Report and Review of Literature. JOP (Online) 2004;5(6):512-515.

Strobel O, Hartwig W, Bergmann F, Hinz U, Hackert T, Grenacher L et al. Anaplastic Pancreatic Cancer: Presentation, Surgical Management and Outcome. Surgery. 2011 Feb 149(2):200-8.

Bergmann F et al. Expression of L1CAM, Cox-2, EGFR, c-KIT and Her2/neu in Anaplastic Pancreatic Cancer: Putative Therapeutic Targets? Histopathology. 2010 Mar;56(4): 440-448.

Hoorens et al. Undifferentiated Carcinoma of the Pancreas: Analysis of Intermediate Filament Profile and Ki-ras Mutations Provides Evidence of a Ductal Origin. J of Pathology 1998 May;185(1)53-60.

Yamaguchi K, et al. Pleomorphic Carcinoma of the Pancreas:Reappraisal of Surgical Resection. Am J Gastroenterology 1998;93:1151-1155.

Clark C, Graham R, Arun J, Harmsen W, Reid-Lombardo K. Clinical Outcomes for Anaplastic Pancreatic Cancer: A Population-Based Study. Journal of the American College of Surgeons 2012 Nov;215(5), 627-634.

Wakatsuki T et al. Complete Response of Anaplastic Pancreatic Carcinoma to Paclitaxel Treatment Selected by Chemosensitivity Testing. Int J Clin Oncol. 2010 June;15(3): 310-313.

O’Reilly EM. Refinement of Adjuvant Therapy for Pancreatic Cancer. JAMA 2010 Sep 8;304(10):1124-1125.

Shinagare AB, Ramaiya NH, Bellizzi AM, Mayer RJ. Locally advanced anaplastic pancreatic adenocarcinoma with initial response to FOLFIRINOX and rapid progression after five months. Pancreatology. 2012 Jan-Feb;12(1):35-8. doi: 10.1016/j.pan.2012.01.001. Epub 2012 Jan 3.

Conroy T et al. FOLFIRINOX versus Gemcitabine for Metastatic Pancreatic Cancer. N Engl J Med. 2011 May 12;364(19):1817-25.

Levy A et al. FOLFIRINOX in Locally Advanced Pancreatic Cancer: The Starting Point for Questioning. Pancreas 2012 Aug;41(6):973-4.

Foreign body giant cells
Published
2013-05-10
How to Cite
JonesT., JonesE., McManusM., ShahR., & GajdosC. (2013). Multifocal Anaplastic Pancreatic Carcinoma Requiring Neoadjuvant Chemotherapy and Total Pancreatectomy: Report of a Case. JOP. Journal of the Pancreas, 14(3), 289-291. https://doi.org/10.6092/1590-8577/1416
Section
CASE REPORTS