Bolanaki Helen, Nikolaou Christina, Pappas Gogos George, Karayiannakis Anastasios J
Second Department of General Surgery, Democritus University of Thrace, Medical School, Alexandroupolis, GRC.
Second Department of Surgery, Democritus University of Thrace/University Hospital of Alexandroupolis, Alexandroupolis, GRC.
Cureus. 2024 Nov 9;16(11):e73357. doi: 10.7759/cureus.73357. eCollection 2024 Nov.
Clear cell pancreatic carcinoma, as a primary lesion, represents a rare malignant entity with very few references. As for the incidence, the clinical characteristics and the prognosis are still to be defined. Here, we present the case of a 73-year-old female who presented with epigastric pain radiating to the back, anorexia, and dyspepsia. Abdominal computed tomography (CT) showed a well-circumscribed, low-attenuating tumor with peripheral enhancement, arising from the upper border of the pancreatic head. There were no metastases or other primary tumors. Radical resection of the tumor was undertaken. Histopathology showed round-to-oval neoplastic cells with a well-defined cell membrane, prominent cell borders, abundant clear cytoplasm, and centrally located nuclei. The periodic acid-Schiff reaction was positive and a diagnosis of primary clear cell pancreatic carcinoma was made. No adjuvant treatment was given. She remained under regular follow-ups with abdominal and thoracic CT scans for seven years without evidence of recurrence of other primary tumors. She was deceased 87 months after tumor resection because of conditions unrelated to the disease. This is the first case to the best of our knowledge, of long-term survival after radical resection of a primary pancreatic clear cell carcinoma, suggesting surgery as a treatment option for this rare tumor and review of the relevant literature.
透明细胞型胰腺癌作为原发性病变,是一种罕见的恶性实体,相关文献极少。至于其发病率、临床特征及预后仍有待明确。在此,我们报告一例73岁女性患者,她表现为上腹部疼痛并放射至背部、厌食及消化不良。腹部计算机断层扫描(CT)显示一个边界清晰、低密度的肿瘤,周边有强化,起源于胰头上缘。无转移灶或其他原发性肿瘤。对该肿瘤进行了根治性切除。组织病理学显示肿瘤细胞呈圆形至椭圆形,细胞膜清晰,细胞边界突出,胞质丰富且透明,细胞核位于中央。过碘酸-希夫反应呈阳性,诊断为原发性透明细胞型胰腺癌。未给予辅助治疗。她接受了为期七年的定期腹部和胸部CT扫描随访,未发现其他原发性肿瘤复发迹象。肿瘤切除87个月后,她因与该疾病无关的情况去世。据我们所知,这是首例原发性胰腺透明细胞癌根治性切除术后长期存活的病例,提示手术可作为这种罕见肿瘤的一种治疗选择,并对相关文献进行了回顾。