title: A case of mixed ductal-endocrine carcinoma of the pancreas.
abstract: A 66-year-old male patient underwent a stomach-preserving pancreatoduodenectomy procedure because of a tumor located around the lower bile duct under the diagnosis of carcinoma of the lower bile duct. The tumor (3.5 × 2.5 cm) was found at the head of the pancreas and had invaded the papillae of Vater at the duodenum. Histology findings indicated both ductal adenocarcinoma and endocrine tumor. The ductal adenocarcinoma component expressed carcinoembryonic antigen, cytokeratin (CK)-19, CK-20, carbohydrate 19-9, and amylase, whereas the endocrine component, which occupied about one-third of the tumor, expressed glucagon, neuron-specific enolase, and chromogranin A. The Ki-67 labeling indices of the two components were 49.7% and 5.3%, respectively. Herein, we present this case of mixed ductal-endocrine carcinoma of the pancreas. Our findings indicate that its aggressive mass may be ascribable to the adenocarcinoma component with a high proliferative potential.
authors.affiliation: Department of Pathology, Nippon Steel Hirohata Hospital, 3-Chome, Yumesakicho, Hirohata-ku, Himeji, Hyogo, 671-1122, Japan. h_hirano@hirohata-hp.or.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hirano
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Terada
authors.forename: Naoko
authors.initials: N
authors.lastname: Yamada
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yamanegi
authors.forename: Hideki
authors.initials: H
authors.lastname: Oyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishigami
authors.forename: Keiji
authors.initials: K
authors.lastname: Nakasho
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology*; D000681:Amylases / Q000378:metabolism; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D053379:Chromogranin A / Q000378:metabolism; D004701:Endocrine Gland Neoplasms / Q000473:pathology* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005934:Glucagon / Q000378:metabolism; D006801:Humans; D053539:Keratin-19 / Q000378:metabolism; D053554:Keratin-20 / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018198:Mixed Tumor, Malignant / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D053379:Chromogranin A; D053539:Keratin-19; D053554:Keratin-20; D019394:Ki-67 Antigen; D005934:Glucagon; D000681:Amylases