Anaplastic ductal carcinoma of the pancreas with more than 10-year postoperative survival. Report of 3 cases

When anaplastic ductal carcinomas of the pancreas are discoverd, the tumors are often very large. They tend to invade locally and metastasize to other organs, and are known to be associated with poorer prognosis than ordinary pancreatic ductal carcinoma. However, we report 3 cases of anaplastic ductal carcinoma of the pancreas associated with survival for more than 10 years after resection. The first case was a 65-year-old male patient who presented with fever of unknown origin. A tumor measuring approximately 10 cm in diameter with enhancement effect was observed in the tail of the pancreas, and distal pancreatectomy and splenectomy was performed. A diagnosis of anaplastic ductal carcinoma of the pancreas, pleomorphic cell type, was made. The patient died of acute myocardial infarction 10 years 1 month after surgery. The second case was a 65-year-old-male patient who presented with typical clinical features of acute pancreatitis. An approximately 6-cm mass with no enhancement effect was observed in the head of the pancreas, and a pylorus-preserving partial pancreatico-duodenectomy (PPPD) was performed. The histopathological diagnosis was anaplastic ductal carcinoma of the pancreas, pleomorphic cell type. The patient remains alive and recurrence-free, 11 year 1 months after surgery. The third case was a 49-year-old man whose initial manifestation was obstructive jaundice and was found to have an approximately 4-cm solid mass in the head of the pancreas. Since the patient had a past history of gastrectomy, pancreatico-duodenectomy was performed. A diagnosis of anaplastic ductal carcinoma of the pancreas, osteoclastoid type, was made, and the patient remains alive and recurrence-free, 11 year 1 months after surgery.