Rasch progrediente Pankreaskopfzyste als Manifestation eines undifferenzierten Pankreaskarzinoms mit osteoklastären Riesenzellen

HISTORY AND FINDINGS ON ADMISSION: A 62 - year old woman presented with acute abdominal pain. INVESTIGATIONS AND DIAGNOSIS: Examination revealed a 3 cm large cyst of the pancreatic head accompanied by an acute pancreatitis. TREATMENT AND COURSE: The cystic mass showed rapid increase. After explorative laparatomy a pancreaticoduodenectomy was performed. Pathologic examination revealed an undifferentiated carcinoma with osteoclast-like giant cells. The tumor growed rapidly and the patient died 10 weeks after admission. CONCLUSIONS: An undifferentiated carcinoma with osteoclast-like giant-cells is a very rare cystic tumor of the pancreas. An accurate preoperative diagnosis of cystic tumors is only achieved in about 30 percent. Therefore, surgical exploration should be considered for all cystic neoplasms and cystic tumors that are not clearly defined.