title: Anaplastic carcinoma of the pancreas with squamous features: report of a case and immunohistochemical study.
abstract: BACKGROUND
  Anaplastic carcinomas of the pancreas are rare aggressive tumors with survival measurable in weeks. Many terms have been applied used to describe these tumors, and anaplastic foci are identified in ductal adenocarcinomas and in ectopic pancreata, but are not the dominant pattern of growth. We herein present our experience with a case of anaplastic carcinoma of the pancreas with squamous features in order that allowed us to delineate the clinicopathologic and immunohistochemical features of this rare entity.
  
  
  METHODS
  According to imaging findings, the 77-year-old Japanese man was diagnosed as the malignant pancreatic tumor, and underwent a surgical resection. Histopathologically, anaplastic tumor cells showed focal ductal and squamous features infiltrated into pancreatic parenchyma, extrapancreatic fatty tissue, and stomach. The tumor cells showed strong reactivity for cytokeratin, alpha-SMA, vimentin, NSE, and S-100 protein. Although immunoreactivity against p53 was negative, strong positive immunostaining for proliferating cell nuclear antigen and interleukin-1 receptor type I (IL-1RI) was observed in a the majority of tumor cells, while the alpha6 integrin subunit was predominantly strong expressed in the adenocarcinomatous lesion. The patient's postoperative course was uneventful and he was treated with a chemotherapy consisting of gemcitabine. After discharging from the hospital, he had subsequently been observed as an outpatient and same chemotherapy was followed by weekly. However, the patient suffered from peritonitis carcinomatosa and re-increases of multiple liver metastases, and he died in the fourteenth month after surgery.
  
  
  CONCLUSIONS
  Our immunohistochemical studies suggested that the prognosis of the case with anaplastic carcinoma presented here would be poor, due to the strong expression of integrins and IL-1RI.
authors.affiliation: Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. cb8h-swi@asahi-net.or.jp
authors.forename: Hirozumi
authors.initials: H
authors.lastname: Sawai
authors.forename: Yuji
authors.initials: Y
authors.lastname: Okada
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Funahashi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Takeyama
authors.forename: Tadao
authors.initials: T
authors.lastname: Manabe
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D016023:Integrins / Q000032:analysis*; D008297:Male; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000556:secondary; D011379:Prognosis; D017472:Receptors, Interleukin-1 / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D016023:Integrins; D017472:Receptors, Interleukin-1