Case Report
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Aug 14, 2010; 16(30): 3853-3856
Published online Aug 14, 2010. doi: 10.3748/wjg.v16.i30.3853
Poorly differentiated endocrine carcinoma of the pancreas responded to gemcitabine: Case report
Shoichi Nakazuru, Toshiyuki Yoshio, Shigeki Suemura, Mari Itoh, Manabu Araki, Chiaki Yoshioka, Makiyo Ohta, Yuka Sueyoshi, Takashi Ohta, Hiroko Hasegawa, Kaori Morita, Takashi Toyama, Noriyoshi Kuzushita, Yoshinori Kodama, Masayuki Mano, Eiji Mita
Shoichi Nakazuru, Toshiyuki Yoshio, Shigeki Suemura, Mari Itoh, Manabu Araki, Chiaki Yoshioka, Makiyo Ohta, Yuka Sueyoshi, Takashi Ohta, Hiroko Hasegawa, Kaori Morita, Takashi Toyama, Noriyoshi Kuzushita, Eiji Mita, Department of Gastroenterology and Hepatology, National Hospital Organization, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka City, Osaka 540-0006, Japan
Yoshinori Kodama, Masayuki Mano, Department of Pathology, National Hospital Organization, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka City, Osaka 540-0006, Japan
Author contributions: Nakazuru S and Yoshio T wrote the paper; Nakazuru S, Suemura S, Itoh M, Araki M, Yoshioka C, Ohta M, Sueyoshi Y, Ohta T, Hasegawa H and Morita K contributed equally to this work; Kodama Y and Mano M made the pathological diagnosis; Toyama T, Kuzushita N and Mita E reviewed the paper.
Correspondence to: Shoichi Nakazuru, MD, Department of Gastroenterology and Hepatology, National Hospital Organization, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka City, Osaka 540-0006, Japan. nakazuru@onh.go.jp
Telephone: +81-6-69421331 Fax: +81-6-69463569
Received: March 17, 2010
Revised: May 26, 2010
Accepted: June 2, 2010
Published online: August 14, 2010
Abstract

Poorly differentiated endocrine carcinoma (PDEC) of the pancreas is a rare and aggressive tumor. First-line treatment is commonly a combination of etoposide and cisplatin, but there is no consensus regarding further treatment recommendations. In this report, we describe a case of pancreatic PDEC treated with gemcitabine as third-line chemotherapy. A 62-year-old man with pancreatic PDEC was administered etoposide plus cisplatin as first-line treatment; he then received irinotecan for tumor relapse. However, because irinotecan induced ileus in this patient, we chose gemcitabine as third-line chemotherapy. After two cycles of gemcitabine (1000 mg/m2 on days 1, 8 and 15 every 4 wk), a partial tumor response was noted by computed tomography (approximately 68% reduction in tumor size). Our patient survived for 15 mo after diagnosis. This is a rare case of unresectable pancreatic PDEC, which showed a partial response to gemcitabine after the failure of two other regimens. Gemcitabine could be an effective treatment option for pancreatic PDEC that is resistant to other treatments.

Keywords: Poorly differentiated endocrine carcinoma, Pancreatic endocrine tumor, Gemcitabine, Chemotherapy