Primary clear cell ductal adenocarcinoma of the pancreas: a case report and clinicopathologic literature review.

Abstract

We present a very rare, interesting case of a carcinoma of the pancreas with predominantly abundant clear cell morphology. According to the WHO classification, primary clear cell carcinoma of the pancreas is classified as a rare "miscellaneous" carcinoma. The tumor was observed in the distal body and tail of the pancreas of a 74-year-old woman. The histopathology of tumor cells showed well-defined cell membranes, clear cytoplasm, and prominent cell boundaries. Immunohistochemical (IHC) staining showed positive reactions to antibodies against vimentin, cytokeratin 7 (CK-7), mucicarmine (MUC-1), periodic acid-Schiff (PAS), periodic acid-Schiff with diastase (PASD), carcinoembryonic antigen (CEA), and Carbohydrate Antigen 19-9 (CA 19-9). On the other hand, IHC staining was negative for alpha-fetoprotein (AFP), cytokeratin 20 (CK-20), HMB45, chromogranin, and synaptophysin. The patient was subsequently diagnosed with a primary solid-type pancreatic clear cell carcinoma with hepatic metastasis. Herein, we report this rare case and include a review of the current literature of this tumor.