Solitary concomitant endocrine tumor and ductal adenocarcinoma of pancreas.
Pancreatic tumors with combined exocrine and endocrine features are rare. Most reported cases are classified as mixed exocrine and endocrine carcinoma of the pancreas. We report the first case of solitary concomitant endocrine tumor and ductal adenocarcinoma of the pancreas. A 58-year-old patient was admitted for uncontrolled diabetes mellitus and body weight loss. The tumor was fortuitously discovered in the pancreatic tail after a tumor survey panel. Grossly, the solitary tumor had a central fibrous band that clearly divided it into two parts. On microscopic examination, the tumor contained both endocrine and exocrine components distinctly separated by the central fibrous band. The exocrine part showed a poorly-differentiated adenocarcinoma. The endocrine part was strongly immunoreactive to chromogranin, synaptophysin and glucagon. We reviewed the literature on pancreatic tumors with combined exocrine and endocrine features. A simple classification for this group of neoplasms is suggested, including five types: amphicrine, mixed, collision, solitary concomitant and multiple concomitant.
Department of Anatomic Pathology, Buddhist Dalin Tzu Chi General Hospital, 2, Min-Sheng Road, Dalin, Chiayi 622, Taiwan, China.
Shu-Mei
SM
Chang
Shih-Tang
ST
Yan
Chang-Kuo
CK
Wei
Chih-Wen
CW
Lin
Chih-En
CE
Tseng
D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D053379:Chromogranin A / Q000378:metabolism; D004701:Endocrine Gland Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D005934:Glucagon / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000628:therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D016708:Synaptophysin / Q000378:metabolism
D014408:Biomarkers, Tumor; D053379:Chromogranin A; D007004:Hypoglycemic Agents; D016708:Synaptophysin; D005934:Glucagon