Elsevier

Clinical Imaging

Volume 40, Issue 1, January–February 2016, Pages 148-151
Clinical Imaging

Case Report
Magnetic resonance imaging findings of undifferentiated carcinoma with osteoclast-like giant cells of pancreas

https://doi.org/10.1016/j.clinimag.2015.09.013Get rights and content

Abstract

Undifferentiated carcinoma with osteoclast-like giant cells is a rare pancreatic and periampullary neoplasm with less than 50 cases reported in the literature. Pathologically, this tumor mimics a giant cell tumor in bones. We report a case of undifferentiated carcinoma with osteoclast-like giant cells in a 55-year-old man presenting as a pancreatic mass with associated regional and distant lymphadenopathy. On T1- and T2-weighted images, the mass shows dark signal intensity which was atypical for a pancreatic adenocarcinoma.

Introduction

Undifferentiated carcinoma with osteoclast-like giant cells (UCOG) of the pancreas is a rare neoplasm comprising less than 1% of all exocrine pancreatic tumors [1], [2]. Less than 50 cases of such tumors have been reported in the English literature. This neoplasm is composed of two distinct cell populations: a mononuclear cell population and osteoclastic tumor giant cells of uncertain lineage. The tumor frequently shows an inhomogeneous appearance with cystic change [1]. The pathogenesis of the tumor is still controversial. Imaging findings for this unusual tumor are seldom reported, and to our knowledge, magnetic resonance imaging (MRI) findings of this tumor have not been reported yet. In this report, we describe a case of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells and imaging findings from both computed tomography (CT) and MRI.

Section snippets

Case report

A 58-year-old man presented with abdominal pain at the left upper quadrant and weight loss of 8 kg over 3 months. Results of routine laboratory examinations including tumor markers such as α-fetoprotein, carbohydrate antigen 19-9, and carcinoembryonic antigen were within normal range.

Ultrasonography (US) revealed a hypoechoic mass in the body of the pancreas (Fig. 1a). Precontrast CT scans showed a 5×5-cm mass lesion arising from the body of the pancreas with subtle high attenuation at the

Discussion

UCOG of the pancreas, formerly known as osteoclast-like giant cell tumor, is a rare neoplasm of the pancreas and comprises less than 1% of nonendocrine pancreatic tumors [1], [2]. This tumor tends to occur in elderly patients with no gender predominance [2], [3], [4]. The symptoms are nonspecific, and the most common signs and symptoms are abdominal pain, a palpable mass, weight loss, fatigue, anorexia, and jaundice. Preoperative imaging diagnosis of the tumor is difficult, and all reported

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