Abstract
Undifferentiated carcinoma of the pancreas is an aggressive but rare tumor for which several other terms have been used to describe its histological appearance. In addition, as osteoclast-like giant cells may accompany undifferentiated carcinoma of the pancreas, the WHO Classification distinguishes undifferentiated carcinoma with osteoclast-like giant cells (UC-OGC) from plain undifferentiated carcinoma since there are a few histopathological and clinical differences. UC-OGC was initially thought to be associated with worse prognosis compared to invasive ductal pancreatic adenocarcinoma, since it is often unresectable at diagnosis and tends to recur rapidly even if completely resected. When true UC-OGGs are carefully dissected out from other anaplastic carcinomas, it becomes, however, clear that UC-OGCs do have more indolent behavior, especially the pure UC-OGCs. This mini-review summarizes the current knowledge on UC-OGC.
Highlights
Undifferentiated carcinoma of the pancreas is an aggressive but rare tumor for which several other terms have been used to describe its histological appearance: anaplastic carcinoma, pleomorphic carcinoma, pleomorphic large cell carcinoma, pleomorphic giant cell carcinoma, spindle cell carcinoma, sarcomatoid carcinoma and carcinosarcoma
Using whole exome sequencing of eight undifferentiated carcinoma with osteoclast-like giant cells (UC-OGC), a recent study demonstrated that genetic alterations observed in UCOGC are closely similar to those identified in carcinogenesis of pancreatic ductal adenocarcinoma and include activating mutations in the oncogene KRAS and inactivating mutations in the tumor suppressor genes CDKN2A, TP53 and SMAD4 [19]
The identification of UC-OGC is important since this tumor has a better prognosis than conventional pancreatic ductal adenocarcinoma and than undifferentiated carcinoma without giant cells
Summary
Undifferentiated carcinoma of the pancreas is an aggressive but rare tumor for which several other terms have been used to describe its histological appearance: anaplastic carcinoma, pleomorphic carcinoma, pleomorphic large cell carcinoma, pleomorphic giant cell carcinoma, spindle cell carcinoma, sarcomatoid carcinoma and carcinosarcoma. In the current WHO Classification, all these terms are lumped together into one single category designated as undifferentiated carcinoma of the pancreas despite their histological differences [1]. As osteoclast-like giant cells may accompany undifferentiated carcinoma of the pancreas, the WHO Classification distinguishes undifferentiated carcinoma with osteoclast-like giant cells (UC-OGCs) from plain undifferentiated carcinoma since there are a few histopathological and clinical differences
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