Osteoclastic Giant Cell Tumor of the Pancreas: Clinicopathological Correlation Study of Twelve Cases.
Dongfeng Tan, William Payne, Thaer Khoury, Wei Li, Nishin A Bhadkamkar, Milind M Javle. University of Texas M.D. Anderson Cancer Center, Houston
Background: Osteoclastic giant cell tumor of the pancreas (OGCTP) is a rare subtype of pancreatic cancer. It has been variably described in case reports as pancreatic cancer with pleomorphic, anaplastic, spindle cell, undifferentiated or mixed histology. Clinical and pathologic data regarding this tumor are very limited.
Design: We conducted a retrospective review of patient records with the above histologies at a single institution from 1994 to 2009. Archival pathology specimens were independently reviewed by two surgical pathologists (WP, DT).
Results: Twelve patients with OGCTP were identified. Demographics: 9 males, median age = 66 (range 49-78), 10 Caucasian, 6 smokers. Median CA 19-9 was 70 IU/mL (range = 1.0-28,373). Site: 6 located in the body or tail, 5 locally advanced, 6 metastatic. For most of the cases (10/12), a large, locally infiltrative mass was frequently seen on imaging studies. Pathologic examination revealed a histologically distinct entity consisting of a heterogeneous but characteristic mixture of bland osteoclast-like giant cells, mononuclear ovoid to spindle cells, large pleomorphic cells with bizarre nuclei, and a more typical adenocarcinoma component. This pattern was seen in all of the examined specimens. Treatment: 2 underwent surgical resection, 7 received gemcitabine or fluoropyrimidine chemotherapy, 3 received radiation. Response: Stable disease or partial response in 4 patients, 1 with long-term response to capecitabine. Median survival of 16.5 months (range = 2-58) was higher than usually noted historically with adenocarcinoma.
Conclusions: This is the largest reported series of OGCTP and identifies this tumor as a distinct clinical and pathological entity. We are conducting additional pathologic studies to further characterize OGCTP.
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 69, Tuesday Afternoon