Curative resection of a small cell carcinoma of the pancreas: Report of a case of long survival without chemotherapy

• Published in: Journal of gastroenterology and hepatology Vol. 19; no. 9; pp. 1087 - 1091
• Main Authors: KINOSHITA, KAZUO, MINAMI, TAKESHI, OHMORI, YOSHIKAZU, KANAYAMA, SHUJI, YOSHIKAWA, KOICHI, TSUJIMURA, TAKAHIRO
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Science Pty 01.09.2004; Blackwell Science
• Subjects: Adult; Biological and medical sciences; Carcinoma, Small Cell - diagnosis; Carcinoma, Small Cell - pathology; Carcinoma, Small Cell - surgery; curative resection; Diagnosis, Differential; Diagnostic Imaging; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Immunohistochemistry; Male; Medical sciences; pancreas; Pancreatectomy; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; small cell carcinoma; Prognosis; Surgical resection; Malignant tumor; Survival; Case study; Chemotherapy; Treatment; Surgery; Gastroenterology; curative resection; Pancreas; Vulcanizing agent; Small cell carcinoma
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2004.02910.x

A 41‐year‐old asymptomatic man was, by chance, diagnosed as having a mass in the left upper quadrant of the abdomen by ultrasound. Computed tomography and magnetic resonance imaging showed a slightly enhanced heterogeneous mass, measuring about 5 cm in diameter, adjacent to the pancreas tail and spleen. On abdominal angiography the tumor was found to be fed by the splenic artery, and no encasement was observed. At operation the tumor was connected to the pancreas tail and attached to the spleen, and no metastasis was evident. As a result of these observations, a curative resection was performed. On histological examination the tumor cells had no ductal or architectural organization and were continuous to the normal pancreatic tissues. The cells were negative for Grimelius argylphile and the periodic acid schiff stain. Immunohistochemistry indicated that the tumor cells were positive for keratin and epithelial membrane antigen, but negative for chromogranin A, vimentin, α1‐antitrypsin and α1‐antichymotrypsin. The tumor was diagnosed as a small cell carcinoma of the pancreas, which is a rare disease. In previously reported cases curative resection of the tumor had not been possible because of its rapid progression and metastasis, and the prognosis is generally very poor. In our case, however, curative resection of the tumor was done, and the patient is healthy with no signs of recurrence for 56 months after the operation and with no additional therapy.