Anaplastic carcinoma of pancreas:report of 6 cases and literature review

Objective:To investigate clinicopathological features,diagnosis and treatment of anaplastic carcinoma of the pancreas and to review relevant literature on this entity. Methods:A retrospective clinical analysis was made in 6 cases of anaplastic pancreatic carcinomas admitted from 1989 to 2001. Results:Anaplastic pancreatic carcinoma was found in 5 men and 1 woman with a mean age of 61.5 years.Tumor location was in the head of the pancreas in 3 patients,body and tail in 3 cases.Tumors were surgically resected in all patients,by pancreaticoduodenectomy in 1,by pancreaticoduodenectomy combined resection and reconstruction of superior mesenteric vein(SMV) in 1,by pancreaticoduodenectomy combined resection and reconstruction of SMV and superior mesenteric artery(SMA) in 1,by distal pancreatectomy in 2,by distal pancreatectomy combined total gastrotectomy in 1.Liver metastasis was found in one patient.Follow-up suggested the prognosis was poor with a mean survival of 5.5 months after operation.All patients were dead with tumor recurrence and liver metastasis. Conclusion:Histologically,anaplastic pancreatic carcinoma is characterized by pleomorphic cell carcinoma consisting of pleomorphic giant/small cells and spindle cells,or osteoclast-like giant cell tumor composed of pleomorphic small cells,or pleomorphic giant cell carcinoma with osteoclastoid giant cells,and demonstrates aggressive biological behavior.Invasions to adjoined organ and metastasis are usual.The prognosis of this tumor appears to be very poor.