Borderline-resectable Undifferentiated Carcinoma with Osteoclast-like Giant Cells of the Pancreas: upfront Surgery or Neoadjuvant Chemotherapy?

Undifferentiated carcinoma with osteoclast-like giant cells (UDC-OGC) of the pancreas is an extremely rare entity, thus an obvious discrepancy regarding their treatment approach exists in the current literature. A 52-year female patient with a two-weeks history of jaundice was diagnosed as borderline-resectable pancreatic mass located in the uncinate process of a size of 5×4 cm. Pancreaticoduodenectomy (PD) with partial portal vein resection was successfully performed following neoadjuvant chemotherapy (NACT). The pathology was interpreted as UDC-OGC without lymph node involvement. Considering their aggressive behavior, NACT followed by surgery seems to be a good option in case of borderline-resectable UDC-OGC. Key Words: Neoadjuvant chemotherapy, Pancreatic neoplasms, Undifferentiated carcinoma, giant cells, Pancreaticoduodenectomy.