Poorly differentiated endocrine carcinoma of the pancreas responded to gemcitabine: Case report

World J Gastroenterol. 2010 Aug 14;16(30):3853-6. doi: 10.3748/wjg.v16.i30.3853.

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/m(2) 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.

Publication types

  • Case Reports

MeSH terms

  • Antimetabolites, Antineoplastic / administration & dosage*
  • Antineoplastic Agents, Phytogenic / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Camptothecin / adverse effects
  • Camptothecin / analogs & derivatives
  • Cell Differentiation*
  • Cisplatin / administration & dosage
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives*
  • Drug Administration Schedule
  • Endocrine Gland Neoplasms / diagnostic imaging
  • Endocrine Gland Neoplasms / drug therapy*
  • Endocrine Gland Neoplasms / pathology
  • Etoposide / administration & dosage
  • Humans
  • Ileus / chemically induced
  • Irinotecan
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / pathology
  • Tomography, X-Ray Computed
  • Treatment Failure

Substances

  • Antimetabolites, Antineoplastic
  • Antineoplastic Agents, Phytogenic
  • Deoxycytidine
  • Etoposide
  • Irinotecan
  • gemcitabine
  • Cisplatin
  • Camptothecin