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7 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Undifferentiated carcinoma with osteoclast-like giant cells is a rare form of pancreatic cancer studded with large bone-eating-type cells that are not themselves cancerous. It grows as a big, well-circumscribed mass, often within a cyst, spreads to nerves and lymph nodes far less often than ordinary pancreatic cancer, and about six in ten patients are alive five years after surgery.
What it is. A WHO variant of ductal adenocarcinoma (Nagtegaal 2020) in which undifferentiated, often spindled or pleomorphic carcinoma cells are mixed with non-neoplastic osteoclast-like giant cells that express the histiocytic marker CD68; the background spindle and giant carcinoma cells often show p53 and often lack cytokeratin, and osteoid was seen in 12 of 38 tumours (Muraki 2016). A 2021 review sets out its pathology and molecular features and the questions it raises (Luchini 2021). Undifferentiated (anaplastic) carcinoma without giant cells is a separate, aggressive variant that this record does not describe.
How it differs from its parent. In 38 resected cases against 725 resected ductal adenocarcinomas, the tumours were larger (mean 5.3 against 3.2 cm), nodular with pushing borders, arose in a mucinous cystic or IPMN-type lesion in 8 cases and showed prominent intraductal or intracystic growth in 61 percent; 76 percent also had an invasive ductal or tubular component. Despite their size, perineural invasion (31.6 against 85.5 percent) and nodal metastasis (22.6 against 64.0 percent) were uncommon, and five-year survival was 59.1 percent against 15.7 percent (Muraki 2016).
| Setting | Approach | Guideline |
|---|---|---|
| Resectable | Resection even of large tumours, given the low rates of nodal and perineural spread and the 59 percent five-year survival in the resected series; adjuvant chemotherapy by extrapolation from ductal adenocarcinoma. | not mapped |
| Advanced | Treated as pancreatic ductal adenocarcinoma: resection with adjuvant chemotherapy when removable, the chemotherapy rows of the parent page when not; the parent record carries the trials. | not mapped |