Clear Cell Carcinoma of the Pancreas -A Case Report and Review of the Literature-
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Most of the malignant neoplasms of the pancreas demonstrate features that are consistent with adenocarcinoma. According to the WHO classification, primary clear cell carcinoma of the pancreas is rare and it is classified as a “miscellaneous” carcinoma. In addition, there is not an adequate systematic overview that can demonstrate its true existence as a definable entity. We report here on an unusual case of primary pancreatic clear cell carcinoma, which is the first such reported case in Korea. A 66 year old woman presented with abdominal pain and significant weight loss over the previous three weeks. On the abdominal computed tomography (CT), we detected an abdominal mass involving the pancreas tail and liver, and clear cell carcinoma with rhabdoid feature was seen on the histologic evaluation. The tumor cells showed well defined cell membranes, clear cytoplasm and prominent cell boundaries. The immunohistochemical stains showed positive reactions to antibodies against pancytokeratin, cytokeratin 7, carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA). On the other hand, there was a negative reaction for cytokeratin 20, chromogranin, synaptophysin, smooth muscle actin and HMB-45. She was diagnosed with a primary pancreatic clear cell carcinoma with hepatic metastasis and she received palliative gemcitabine chemotherapy. The patient died one month later of pancreatic cancer progression.
Abstract
Most of the malignant neoplasms of the pancreas demonstrate features that are consistent with adenocarcinoma. According to the WHO classification, primary clear cell carcinoma of the pancreas is rare and it is classified as a “miscellaneous” carcinoma. In addition, there is not an adequate systematic overview that can demonstrate its true existence as a definable entity. We report here on an unusual case of primary pancreatic clear cell carcinoma, which is the first such reported case in Korea. A 66 year old woman presented with abdominal pain and significant weight loss over the previous three weeks. On the abdominal computed tomography (CT), we detected an abdominal mass involving the pancreas tail and liver, and clear cell carcinoma with rhabdoid feature was seen on the histologic evaluation. The tumor cells showed well defined cell membranes, clear cytoplasm and prominent cell boundaries. The immunohistochemical stains showed positive reactions to antibodies against pancytokeratin, cytokeratin 7, carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA). On the other hand, there was a negative reaction for cytokeratin 20, chromogranin, synaptophysin, smooth muscle actin and HMB-45. She was diagnosed with a primary pancreatic clear cell carcinoma with hepatic metastasis and she received palliative gemcitabine chemotherapy. The patient died one month later of pancreatic cancer progression.
참고문헌 (14)
- Annual Report on the Cause of Death Statistics, "Korean National Statistics Office", Korean National Statistics Office, ~ (2007)
- Zamboni G, "Tumours of the exocrine pancreas. in Pathology and genetics of tumours of the digestive system", pp.221~250 (2000), IARC Press
- Wick MR, "Clear cell neoplasms of the endocrine system and thymus", Semin Diagn Pathol, 14, pp.183~202 (1997)
- Ritter JH, "Clear cell tumors of the alimentary tract and abdominal cavity", Semin Diagn Pathol, 14, pp.213~219 (1997)
- Paik SS, "Clear cell islet cell tumor of the pancreas: an immunohistochemical and ultrastructual study", Korean J Pathol, 31, pp.162~166 (1997)
- Ray S, "Clear cell ductal adenocarcinoma of pancreas: a case report and review of literature", Arch Pathol Lab Med, 128, pp.693~696 (2004)
- Kanai N, "Clear cell carcinoma of the pancreas", Acta Pathol Jpn, 37, pp.1521~1526 (1987)
- Lüttges J, "Clear cell carcinoma of the pancreas: an adenocarcinoma with ductal phenotype", Histopathology, 32, pp.444~448 (1998)
- Jamali M, "Adenosquamous carcinoma of the pancreas with clear cell and rhabdoid components", JOP, 8, pp.330~334 (2007)
- Sasaki A, "Clear cell carcinoma of the pancreas: an adenocarcinoma with unusual phenotype of duct cell origin", J Hepatobiliary Pancreat Surg, 11, pp.140~144 (2004)
- Kim L, "Clear cell carcinoma of the pancreas: histopathologic features and a unique biomarker: hepatocyte nuclear factor-1β", Mod Pathol, 21, pp.1075~1083 (2008)
- Weeks DA, "Rhabdoid tumor. An entity or a phenotype?", Arch Pathol Lab Med, 113, pp.113~114 (1989)
- Urdiales-Viedma M, "Squamous cell carcinoma of the penis with rhabdoid features", Ann Diagn Pathol, 6, pp.381~384 (2002)
- Tada M, "Clinical application of ras gene mutation for diagnosis of pancreatic adenocarcinoma", Gastroenterology, 100, pp.233~238 (1991)