Yukio Matsui

Adenosquamous carcinoma of the pancreas: A clinicopathologic study and report of three cases

Among 27 surgically resected carcinomas of the pancreas, 3 cases were diagnosed histologically as adenosquamous carcinoma (11.1%). This is the highest rate among the medical literature we reviewed. Since a very small focus of squamous cell carcinoma was detected through close observation in 1 case, it would seem that this sort of pancreatic tumor could be more common than is ordinarily expected. From the histologic studies of these 3 cases, it seems likely that the preexisting adenocarcinoma partially underwent malignant transformation into a malignant squamous component. When the different modes of spread of these two histologic elements are compared, the adenocarcinomatous element seems to be more invasive and more likely to metastasize than does squamous cell carcinoma.

Coexistence of bilateral pheochromocytoma and pancreatic islet cell tumor. Report of a case and review of the literature

A 14‐year‐old Japanese male with a previously undescribed combination of bilateral pheochromocytoma and an islet cell tumor of the pancreas is presented. The combination of endocrine neoplasms in this patient overlaps multiple endocrine neoplasia (MEN) Type 1 and Type 2. A total of 14 reported cases of MEN overlapping Type 1 and Type 2 is reviewed. Of the 14, 7 patients with acromegaly developed a paraganglioma(s), 2 patients with Sipple syndrome had a pituitary adenoma, and in the other 5 patients, an intestinal carcinoid or a pancreatic islet‐cell tumor occurred in association with either a thyroid medullary carcinoma or a paraganglioma(s). We believe that the occurrence of MEN overlapping Type 1 and Type 2 is more than a fortuitous association, and can be explained on the basis of the neuroectodermal origin. Cancer 42:2928–2934, 1978.

Carcinoid tumor of the gallbladder associated with adenocarcinoma.

A case of carcinoid tumor of the gallbladder associated with adenocarcinoma in a 56‐year‐old man is reported and a review of the literature is made. The tumor was a polypoid mass with a size of 5.5 × 4.0 × 2.8 cm. Histologically, the tumor showed carcinoid and adenocarcinoma with areas of mucous change. Tumor cells containing argyrophil granules were observed in both carcinoidal and adenocarcinomatous areas, but no argentaffin granules were detected in either of the neoplastic areas. Some of the tumor cells had both argyrophil granules and mucin in the same cytoplasm. The electron microscopic study revealed several tumor cells containing neurosecretory granules; however, no clinical signs of hormonal activities of the tumor were observed. The patient died of generalized bone metastases 16 months after surgery. This appears to be the second case of composite tumor of the gallbladder.

Leiomyosarcoma of the pancreas. Report of a case and review of the literature.

A case of leiomyosarcoma of the pancreas, occurring in a 44-year-old male, is reported. With a preoperative diagnosis of cystadenocarcinoma, the patient underwent surgical resection of a cystic tumor in the head of the pancreas. There were no metastases noted at the time. The resected specimen was diagnosed histologically as a smooth muscle tumor originating from the pancreas. It was seemingly benign on the basis of the mitotic counts and the degree of cellular atypism. However, the tumor proved to be malignant; the patient died with metastases to the liver. The tumor at autopsy also had few mitoses (0-1/10 hpf). The previously reported cases were reviewed and the limitations of histological diagnosis in assessing malignant potential of smooth muscle tumors are discussed.