An autopsy case of anaplastic carcinoma of the pancreas in a 39-year-old woman that developed from hereditary pancreatitis

Shogo Ota, Gensho Tanke, Satsuki Asai, Ryo Ito, Kazuya Hara, Yutaka Takada, Kanna Adachi, Yukari Shimada, Motohito Hayashi, Toshinao Itani, Misa Ishihara, Atsushi Masamune

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Abstract

Patient: Female, 39-year-old Final Diagnosis: Anaplastic carcinoma of the pancreas • pancreatic cancer Symptoms: Epigastralgia • jaundice Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology • Oncology Objective: Background: Case Report: Conclusions: Rare disease Anaplastic carcinoma of the pancreas (ACP) is a rare type of cancer with an extremely poor prognosis. Hereditary pancreatitis is a rare autosomal-dominant disease. It progresses to chronic pancreatitis at a young age, increas-ing the risk of pancreatic cancer. A 39-year-old woman was diagnosed with chronic pancreatitis at the age of 18 years. The patient was referred to our hospital for epigastralgia and jaundice. We identified a tumor mass at the head of the pancreas using contrast computed tomography (CT) and endoscopic ultrasound (EUS) of the abdomen. Tissue biopsy re-vealed ACP of the spindle cell type. We started the patient on combination chemotherapy using gemcitabine and nanoparticle albumin-bound (nab)-paclitaxel, but she died 1 month after her first visit. An autopsy re-vealed a mixture of tubular adenocarcinoma and anaplastic carcinoma. We performed genetic analysis using DNA samples from the biopsy tissues but did not find mutations in the PRSS1 and SPINK1 genes associated with hereditary pancreatitis. The risk of pancreatic cancer generally increases in patients with hereditary pancreatitis after 50 years of age. However, in this case, the development of pancreatic cancer occurred at a younger age, suggesting the impor-tance of early detection in such cases. Furthermore, this case suggests that EUS is a useful method for moni-toring patients with hereditary pancreatitis and the diagnosis of ACP.

Original languageEnglish
Article numbere928993
Pages (from-to)1-9
Number of pages9
JournalAmerican Journal of Case Reports
Volume22
Issue number1
DOIs
Publication statusPublished - 2021

Keywords

  • Adenocarcinoma
  • Carcinoma, pancreatic ductal
  • Endoscopic ultrasound-guided fine needle aspiration
  • Genetic diseases, inborn
  • Pancreatic neoplasms
  • Pancreatitis, chronic

ASJC Scopus subject areas

  • Medicine(all)

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