title: A spindle cell anaplastic pancreatic carcinoma with rhabdoid features following curative resection.
abstract: Anaplastic pancreatic carcinoma (ANPC) accounts for ~5% of all pancreatic ductal adenocarcinoma cases. Due to its rarity, its clinical features and surgical outcomes remain to be clearly understood. A 74-year-old woman was admitted to Onomichi General Hospital (Onomichi, Japan) in April 2015 without any significant past medical history. Contrast-enhanced computed tomography (CT) revealed a 9.5×8.0 cm tumor in the body and tail of the pancreas. The patient developed acute abdominal pain 3 weeks later and the CT revealed massive abdominal bleeding caused by tumor rupture. The tumor increased in size and reached 12.0×10.0 cm in maximal diameter. The tumor doubling time was estimated to be 13 days.18F-fluorodeoxyglucose (FDG) positron emission tomography/CT confirmed the absence of distant metastasis since FDG accumulation was detected only in the tumor lesion. Emergency distal pancreatectomy and splenectomy were performed. Histologically, the tumor was classified as a spindle cell ANPC with rhabdoid features. The patient succumbed to mortality 8 months following the surgery while undergoing systemic adjuvant chemotherapy for multiple liver metastases. ANPC is difficult to detect in the early stages due to its progressive nature and atypical radiological findings. Long-term survival can be achieved only by curative resection; therefore, surgical resection must be performed whenever possible, even if the chance of long-term survival following surgery is considered dismal. As the present case suggested, spindle cell ANPC with rhabdoid features is highly aggressive and curative-intent resection must not be delayed.
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima 722-8508, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima 722-8508, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Amano
authors.affiliation: Department of Gastroenterology, Onomichi General Hospital, Onomichi, Hiroshima 722-8508, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hanada
authors.affiliation: Department of Gastroenterology, Onomichi General Hospital, Onomichi, Hiroshima 722-8508, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Okazaki
authors.affiliation: Department of Pathology, Onomichi General Hospital, Onomichi, Hiroshima 722-8508, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Yonehara
authors.affiliation: Department of Surgery, Innoshima-Ishikai Hospital, Innoshima, Hiroshima 1722-2323, Japan.
authors.forename: Fumito
authors.initials: F
authors.lastname: Kuranishi
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima 722-8508, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakahara
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima 722-8508, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kuroda
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima 722-8508, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Onomichi, Hiroshima 1734-8551, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Noriyuki
keywords: anaplastic carcinoma; pancreas; rhabdoid features; spindle cell type