J Korean Soc Radiol.  2019 May;80(3):585-590. 10.3348/jksr.2019.80.3.585.

Undifferentiated Carcinoma with Osteoclast-Like Giant Cells of the Pancreas Mimicking a Predominantly Calcified Mass: Case Report and Literature Review

• Choi TS
• Lee J
• Kim BH
• Choi JW
• Kim KA
• Park CM

• KMID: 2454040
• DOI: http://doi.org/10.3348/jksr.2019.80.3.585

Abstract

Undifferentiated carcinoma with osteoclast-like giant cells (UCOGCs) of the pancreas is a rare neoplasm that contains osteoclast-like giant cells, which are morphologically identical to those seen in giant cell tumors of bones. Histopathologically, it is composed of round to spindle-shaped neoplastic cells and non-neoplastic histiocytic giant cells. Although only limited radiologic findings are available due to the rarity of this tumor, UCOGCs shows variable imaging features in the literature from an inhomogeneous solid mass to a multilocular cystic tumor. Herein, we report an unusual manifestation of UCOGCs of the pancreas mimicking a predominantly calcified mass with radiologic-pathologic correlation.

MeSH Terms

Carcinoma*
Giant Cell Tumors
Giant Cells*
Pancreas*
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 CT findings of Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas in a 53-year-old man. A. Precontrast CT image reveals a predominantly high-attenuation mass (100–140 HU), measuring 5.8 × 4.3 cm, considered to represent calcifications in the body of the pancreas (arrows). B. Contrast-enhanced CT image at the pancreatic phase demonstrates heterogeneous, strong enhancement of the mass (arrows). C. Contrast-enhanced CT image at the portal venous phase shows mild enhancement of the pancreatic mass and an atrophic change of the pancreas tail (arrowheads) without main pancreatic duct dilatation. The pancreatic mass directly invades the posterior wall of the gastric high body (arrow). D. Microscopically, a mixture of spindle-shaped, variably pleomorphic neoplastic cells and scattered multinucleated OGCs (arrows) among neoplastic cells are observed with hemorrhagic areas (H&E, ×100). Ossifications were sparse within the tumor (not shown). E, F. Immunohistochemical staining reveals strong reactivity for the histiocytic marker CD68 (E) in OGCs and some tumor cells and for vimentin (F) in neoplastic cells and OGCs (H&E, × 200). H&E = hematoxylin-eosin stain, OGCs = osteoclast-like giant cells

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