Conversion surgery for undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a case report

Abstract Background Undifferentiated carcinoma with osteoclast-like giant cells (UCOGCs) is a rare subtype of pancreatic cancer (PC), and its clinicopathological characteristics are still unclear. Herein, we report a case of initially unresectable UCOGC that was successfully resected after FOLFIRINO...

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Main Authors: Yosuke Igarashi, Takeshi Gocho, Tomohiko Taniai, Tadashi Uwagawa, Ryoga Hamura, Yoshihiro Shirai, Jungo Yasuda, Koichiro Haruki, Kenei Furukawa, Toru Ikegami
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Language:English
Published: Japan Surgical Society 2022-03-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-022-01385-x
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author Yosuke Igarashi
Takeshi Gocho
Tomohiko Taniai
Tadashi Uwagawa
Ryoga Hamura
Yoshihiro Shirai
Jungo Yasuda
Koichiro Haruki
Kenei Furukawa
Toru Ikegami
author_facet Yosuke Igarashi
Takeshi Gocho
Tomohiko Taniai
Tadashi Uwagawa
Ryoga Hamura
Yoshihiro Shirai
Jungo Yasuda
Koichiro Haruki
Kenei Furukawa
Toru Ikegami
author_sort Yosuke Igarashi
collection DOAJ
description Abstract Background Undifferentiated carcinoma with osteoclast-like giant cells (UCOGCs) is a rare subtype of pancreatic cancer (PC), and its clinicopathological characteristics are still unclear. Herein, we report a case of initially unresectable UCOGC that was successfully resected after FOLFIRINOX therapy. Case presentation A 63-year-old man was referred to us for evaluation of a pancreatic mass detected by computed tomography (CT) during a medical checkup. Computed tomography showed a 7.5-cm tumor located in the pancreatic head and body, which involved the common hepatic artery (CHA), gastroduodenal artery (GDA), and main portal vein (PV) with tumor thrombus. UCOGC was suspected by endoscopic ultrasonography-guided fine needle aspiration, and the patient was diagnosed with unresectable locally advanced pancreatic cancer. After ten cycles of FOLFIRINOX, the tumor size decreased to 3 cm and the tumor thrombus in the main portal trunk had disappeared in the follow-up CT scan. However, the patient experienced severe adverse drug reactions, including neutropenia and liver dysfunction. Therefore, we performed pancreatoduodenectomy with portal vein resection. The pathological diagnosis was UCOGC with a negative tumor margin. He was treated with FOLFIRINOX, and remains recurrence-free for 6 months after surgery. Conclusions We experienced a case undergoing conversion surgery for unresectable UCOGC, which resulted in R0 resection. FOLFIRINOX could be a possible regimen to achieve conversion surgery for UCOGC.
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spelling doaj-art-7c9a4bc3ff594650acfb9b2a7ac0dd242025-08-20T02:52:26ZengJapan Surgical SocietySurgical Case Reports2198-77932022-03-01811510.1186/s40792-022-01385-xConversion surgery for undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a case reportYosuke Igarashi0Takeshi Gocho1Tomohiko Taniai2Tadashi Uwagawa3Ryoga Hamura4Yoshihiro Shirai5Jungo Yasuda6Koichiro Haruki7Kenei Furukawa8Toru Ikegami9Division of Hepatobiliary and Pancreas, The Jikei University School of MedicineDivision of Hepatobiliary and Pancreas, The Jikei University School of MedicineDivision of Hepatobiliary and Pancreas, The Jikei University School of MedicineDivision of Hepatobiliary and Pancreas, The Jikei University School of MedicineDivision of Hepatobiliary and Pancreas, The Jikei University School of MedicineDivision of Hepatobiliary and Pancreas, The Jikei University School of MedicineDivision of Hepatobiliary and Pancreas, The Jikei University School of MedicineDivision of Hepatobiliary and Pancreas, The Jikei University School of MedicineDivision of Hepatobiliary and Pancreas, The Jikei University School of MedicineDivision of Hepatobiliary and Pancreas, The Jikei University School of MedicineAbstract Background Undifferentiated carcinoma with osteoclast-like giant cells (UCOGCs) is a rare subtype of pancreatic cancer (PC), and its clinicopathological characteristics are still unclear. Herein, we report a case of initially unresectable UCOGC that was successfully resected after FOLFIRINOX therapy. Case presentation A 63-year-old man was referred to us for evaluation of a pancreatic mass detected by computed tomography (CT) during a medical checkup. Computed tomography showed a 7.5-cm tumor located in the pancreatic head and body, which involved the common hepatic artery (CHA), gastroduodenal artery (GDA), and main portal vein (PV) with tumor thrombus. UCOGC was suspected by endoscopic ultrasonography-guided fine needle aspiration, and the patient was diagnosed with unresectable locally advanced pancreatic cancer. After ten cycles of FOLFIRINOX, the tumor size decreased to 3 cm and the tumor thrombus in the main portal trunk had disappeared in the follow-up CT scan. However, the patient experienced severe adverse drug reactions, including neutropenia and liver dysfunction. Therefore, we performed pancreatoduodenectomy with portal vein resection. The pathological diagnosis was UCOGC with a negative tumor margin. He was treated with FOLFIRINOX, and remains recurrence-free for 6 months after surgery. Conclusions We experienced a case undergoing conversion surgery for unresectable UCOGC, which resulted in R0 resection. FOLFIRINOX could be a possible regimen to achieve conversion surgery for UCOGC.https://doi.org/10.1186/s40792-022-01385-xUndifferentiated carcinoma with osteoclast-like giant cellsConversion surgeryPancreatic ductal adenocarcinomaFOLFIRINOX
spellingShingle Yosuke Igarashi
Takeshi Gocho
Tomohiko Taniai
Tadashi Uwagawa
Ryoga Hamura
Yoshihiro Shirai
Jungo Yasuda
Koichiro Haruki
Kenei Furukawa
Toru Ikegami
Conversion surgery for undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a case report
Surgical Case Reports
Undifferentiated carcinoma with osteoclast-like giant cells
Conversion surgery
Pancreatic ductal adenocarcinoma
FOLFIRINOX
title Conversion surgery for undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a case report
title_full Conversion surgery for undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a case report
title_fullStr Conversion surgery for undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a case report
title_full_unstemmed Conversion surgery for undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a case report
title_short Conversion surgery for undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a case report
title_sort conversion surgery for undifferentiated carcinoma with osteoclast like giant cells of the pancreas a case report
topic Undifferentiated carcinoma with osteoclast-like giant cells
Conversion surgery
Pancreatic ductal adenocarcinoma
FOLFIRINOX
url https://doi.org/10.1186/s40792-022-01385-x
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