CARCINOMA PANCREÁTICO DE CÉLULAS GIGANTES DE TIPO OSTEOCLÁSTICO

Originalmente descrito ha 40 anos (Rosai), o carcinoma indiferenciado de celulas gigantes tipo osteoclastico (CICGO) e uma variante do adenocarcinoma dos ductos e corresponde a menos de 1% dos tumores do pâncreas exocrino. A sua extrema raridade, com consequente existencia de poucos relatos e experiencia clinica, suscita algumas duvidas quanto a sua histogenese, tipos de abordagem e atitude terapeutica. De realcar que na revisao da litera-tura nao encontramos nenhum caso descrito em Portugal. Apresenta-se o caso de uma doente de 61 anos, admitida no Servico de Medicina III dos HUC com uma massa volumosa intra-abdominal, no hipocondrio esquerdo, e anemia microcitica, tendo sido identificada neoplasia pancreatica no decorrer do estudo em internamento. Foi submetida a resseccao cirurgica, tendo o estudo anatomo-patologico do tumor identificado CICGO. Discutem-se as particularidades do caso, as opcoes terapeuticas utilizadas e a sua evolucao; inclui-se uma revisao da literatura. INDIFFERENTIATED OSTEOCLASTIC-TYPE GIANT CELL CARCINOMA Initially described 40 years ago (Rosai), the undifferentiated osteoclastic-type giant cell carcinoma (IOGCC) is a variant of ductal adenocarcinoma and accounts for less than 1% of exocrine pancreatic tumors. Its extreme rarity, with consequent existence of few reports and clinical experience, leads to the arousal of doubts with regard to its histogenesis, types of approach and therapeutical attitudes. It is important to note that in Portugal no similar case is registered in medical literature. A 61 year old patient admitted to the Internal Medicine Ward 3 at Coimbra University Hospital presents with a volumous intra-abdominal mass in the left hypochondrium and microcytic anemia. During the investigation, a pancreatic neoplasm was identified, and the patient was submitted to surgical resection, the anatomo-pathological study of the tumor having revealed IOGCC. The particularities of the case, current available therapeutical options and its evolution are discussed, as well as a revision of the existing literature.