title: Osteoclastic giant cell tumor of the pancreas.
abstract: BACKGROUND
  Pancreatic giant cell tumors are rare, with an incidence of less than 1% of all pancreatic tumors. Osteoclastic giant cell tumor (OGCT) of the pancreas is one of the three types of PGCT, which are now classified as undifferentiated carcinoma with osteoclast-like giant cells.
  
  
  METHODS
  The patient is a 57 year old woman who presented with a 3 week history of epigastric pain and a palpable abdominal mass. Imaging studies revealed an 18cm×15cm soft tissue mass with cystic components which involved the pancreas, stomach and spleen. Exploratory laparotomy with distal pancreatectomy, partial gastrectomy and splenectomy was performed. Histology revealed undifferentiated pancreatic carcinoma with osteoclast-like giant cells with production of osteoid and glandular elements.
  
  
  CONCLUSIONS
  OGCT of the pancreas resembles benign-appearing giant cell tumors of bone, and contain osteoclastic-like multinucleated cells and mononuclear cells. OGCTs display a less aggressive course with slow metastasis and lymph node spread compared to pancreatic adenocarcinoma. Due to the rarity of the cancer, there is a lack of prospective studies on treatment options. Surgical en-bloc resection is currently considered first line treatment. The role of adjuvant therapy with radiotherapy or chemotherapy has not been established.
  
  
  CONCLUSIONS
  Pancreatic giant cell tumors are rare pancreatic neoplasms with unique clinical and pathological characteristics. Osteoclastic giant cell tumors are the most favorable sub-type. Surgical en bloc resection is the first line treatment. Long-term follow-up of patients with these tumors is essential to compile a body of literature to help guide treatment.
authors.affiliation: Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430, United States. Electronic address: wudneh.temesgen@ttuhs.edu.
authors.forename: Wudneh M
authors.initials: WM
authors.lastname: Temesgen
authors.affiliation: Department of Pathology, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430-8115, United States. Electronic address: mitchel.wachtel@ttuhsc.edu.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Wachtel
authors.affiliation: Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430, United States. Electronic address: Sharmila.dissanaike@ttuhsc.edu.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Dissanaike
keywords: Giant cell; Osteoclastic; Pancreas