Human Pathology
Volume 41, Issue 1 , Pages 113-122 , January 2010

Resected pancreatic adenosquamous carcinoma: clinicopathologic review and evaluation of adjuvant chemotherapy and radiation in 38 patients

  • K. Ranh Voong, BA

      Affiliations

    • Department of Radiation Oncology and Molecular Radiation Sciences, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Jon Davison, MD

      Affiliations

    • Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Timothy M. Pawlik, MD

      Affiliations

    • Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Manuel O. Uy, PhD

      Affiliations

    • Department of Radiation Oncology and Molecular Radiation Sciences, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Charles C. Hsu, MD

      Affiliations

    • Department of Radiation Oncology and Molecular Radiation Sciences, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Jordan Winter, MD

      Affiliations

    • Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Ralph H. Hruban, MD

      Affiliations

    • Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Daniel Laheru, MD

      Affiliations

    • Department of Medical Oncology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Sonali Rudra, MD

      Affiliations

    • Department of Radiation Oncology and Molecular Radiation Sciences, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Michael J. Swartz, MD

      Affiliations

    • Department of Radiation Oncology and Molecular Radiation Sciences, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Hari Nathan, MD

      Affiliations

    • Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Barish H. Edil, MD

      Affiliations

    • Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Richard Schulick, MD

      Affiliations

    • Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • John L. Cameron, MD

      Affiliations

    • Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Christopher L. Wolfgang, MD

      Affiliations

    • Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • ,
  • Joseph M. Herman, MD, MSc

      Affiliations

    • Department of Radiation Oncology and Molecular Radiation Sciences, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD 21231-6681, USA
    • Corresponding Author InformationCorresponding author.

Received 27 May 2009 ,Revised 20 July 2009 ,Accepted 22 July 2009.

References 

  1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71–96
  2. Herman JM, Swartz MJ, Hsu CC, et al. Analysis of fluorouracil-based adjuvant chemotherapy and radiation after pancreaticoduodenectomy for ductal adenocarcinoma of the pancreas: results of a large, prospectively collected database at the Johns Hopkins Hospital. J Clin Oncol. 2008;26:3503–3510
  3. Cihak RW, Kawashima T, Steer A. Adenoacanthoma (adenosquamous carcinoma) of the pancreas. Cancer. 1972;29:1133–1140
  4. Cubilla AL, Fitzgerald PJ. Morphological patterns of primary nonendocrine human pancreas carcinoma. Cancer Res. 1975;35:2234–2248
  5. Madura JA, Jarman BT, Doherty MG, et al. Adenosquamous carcinoma of the pancreas. Arch Surg. 1999;134:599–603
  6. Kardon DE, Thompson LD, Przygodzki RM, et al. Adenosquamous carcinoma of the pancreas: a clinicopathologic series of 25 cases. Mod Pathol. 2001;14:443–451
  7. Hsu JT, Yeh CN, Chen YR, Chen HM, Hwang TL, et al. Adenosquamous carcinoma of the pancreas. Digestion. 2005;72:104–108
  8. Hruban RH, Pitman MB, Klimstra DS. Tumors of the pancreas. In:  Silverberg SG,  Sobin LH editor. AFIP Atlas of Tumor Pathology, Series 4, Fascicle 6. Washington, DC: American Registry of Pathology; 2007;p. 177–181
  9. Yeo CJ, Abrams RA, Grochow LB, Sohn TA, Ord SE, et al. Pancreaticoduodenectomy for pancreatic adenocarcinoma: postoperative adjuvant chemoradiation improves survival. A prospective, single-institution experience. Ann Surg. 1997;225:621–633[discussion 633-6]
  10. Yamaue H, Tanimura H, Onishi H, et al. Adenosquamous carcinoma of the pancreas: successful treatment with extended radical surgery, intraoperative radiation therapy, and locoregional chemotherapy. Int J Pancreatol. 2001;29:53–58
  11. Shibagaki K, Fujita K, Nakayama S, et al. Complete response of a pancreatic adenosquamous carcinoma to chemoradiotherapy. Int J Clin Oncol. 2008;13:74–77
  12. Sall J, Creighton L, Lehman A. JMP start statistics. 4th ed.. Cary (NC): SAS Publishing, SAS Institute; 2007;
  13. Moeschberger ML, Klein JP. Statistical methods for dependent competing risks. Lifetime Data Anal. 1995;1:195–204
  14. Oettle H, Neuhaus P. Adjuvant therapy in pancreatic cancer: a critical appraisal. Drugs. 2007;67:2293–2310
  15. Alwaheeb S, Chetty R. Adenosquamous carcinoma of the pancreas with an acantholytic pattern together with osteoclast-like and pleomorphic giant cells. J Clin Pathol. 2005;58:987–990
  16. Aranha GV, Yong S, Olson M. Adenosquamous carcinoma of the pancreas. Int J Pancreatol. 1999;26:85–91[Abstract]
  17. Campman SC, Fajardo MA, Rippon MB, et al. Adenosquamous carcinoma arising in a mucinous cystadenoma of the pancreas. J Surg Oncol. 1997;64:159–162
  18. Ishikawa O, Matsui Y, Aoki I, Iwanaga T, Terasawa T, et al. Adenosquamous carcinoma of the pancreas: a clinicopathologic study and report of three cases. Cancer. 1980;46:1192–1196
  19. Komatsuda T, Ishida H, Konno K, et al. Adenosquamous carcinoma of the pancreas: report of two cases. Abdom Imaging. 2000;25:420–423
  20. Kovi J. Adenosquamous carcinoma of the pancreas: a light and electron microscopic study. Ultrastruct Pathol. 1982;3:17–23
  21. Layfield LJ, Cramer H, Madden J, et al. Atypical squamous epithelium in cytologic specimens from the pancreas: cytological differential diagnosis and clinical implications. Diagn Cytopathol. 2001;25:38–42
  22. Leiman G, Markowitz S, Svensson LG. Intraoperative cytodiagnosis of pancreatic adenosquamous carcinoma: a case report. Diagn Cytopathol. 1986;2:72–75
  23. Lozano MD, Panizo A, Sola IJ, et al. FNAC guided by computed tomography in the diagnosis of primary pancreatic adenosquamous carcinoma. A report of three cases. Acta Cytol. 1998;42:1451–1454
  24. Jamali M, Serra S, Chetty R. Adenosquamous carcinoma of the pancreas with clear cell and rhabdoid components. A case report. JOP. 2007;8:330–334
  25. Nabae T, Yamaguchi K, Takahata S, et al. Adenosquamous carcinoma of the pancreas: report of two cases. Am J Gastroenterol. 1998;93:1167–1170[Abstract]
  26. Wilczynski SP, Valente PT, Atkinson BF. Cytodiagnosis of adenosquamous carcinoma of the pancreas. Use of intraoperative fine needle aspiration. Acta Cytol. 1984;28:733–736
  27. Yamaguchi K, Enjoji M. Adenosquamous carcinoma of the pancreas: a clinicopathologic study. J Surg Oncol. 1991;47:109–116[Abstract]
  28. Smoot RL, Zhang L, Sebo TJ, et al. Adenosquamous carcinoma of the pancreas: a single-institution experience comparing resection and palliative care. J Am Coll Surg. 2008;207:368–370
  29. Hsu JT, Chen HM, Wu RC, et al. Clinicopathologic features and outcomes following surgery for pancreatic adenosquamous carcinoma. World J Surg Oncol. 2008;6:95
  30. Okabayashi T, Hanazaki K. Surgical outcome of adenosquamous carcinoma of the pancreas. World J Gastroenterol. 2008;14:6765–6770
  31. Brody JR, Costantino CL, Potoczek M, et al. Adenosquamous carcinoma of the pancreas harbors KRAS2, DPC4 and TP53 molecular alterations similar to pancreatic ductal adenocarcinoma. Mod Pathol. 2009;22:651–659
  32. Rahemtullah A, Misdraji J, Pitman MB. Adenosquamous carcinoma of the pancreas: cytologic features in 14 cases. Cancer. 2003;99:372–378
  33. Murakami Y, Yokoyama T, Yokoyama Y, et al. Adenosquamous carcinoma of the pancreas: preoperative diagnosis and molecular alterations. J Gastroenterol. 2003;38:1171–1175

 Presented as a poster at the 49th annual meeting of the American Society for Therapeutic Radiology and Oncology, Los Angeles, CA, 2007.

PII: S0046-8177(09)00276-7

doi: 10.1016/j.humpath.2009.07.012

Human Pathology
Volume 41, Issue 1 , Pages 113-122 , January 2010

Article Tools

* Image Usage & Resolution