Basaloid carcinoma of the pancreas—clinicopathological presentation and oncogenetic snapshot of a rare entity

Szasz, A. Marcell and Szirtes, Ildiko and Tihanyi, Balazs and Barkaszi, Bernadett and Baranyai, Zsolt and Tihanyi, Tibor and Harsanyi, Laszlo and Timar, Jozsef and Kulka, Janina (2015) Basaloid carcinoma of the pancreas—clinicopathological presentation and oncogenetic snapshot of a rare entity. Virchows Archiv, 466 (2). pp. 237-241. ISSN 0945-6317

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Abstract

We report a case of basaloid pancreatic carcinoma with clinical, pathological, and genomic data. The 73-year-old male patient had jaundice, acholic stool, diarrhea, weight loss, and a large, painless gall bladder. His GGT was highly elevat- ed. The pancreatic head contained a tumor, which was resected by partial pancreatoduodenectomy with pancreato- gastric anastomosis, cholecystectomy, and lymphadenectomy. On gross examination, a 3.8-cm white firm nodule was found, which microscopically was composed of basaloid cell nests with a less than usual desmoplastic stromal background and focally PANIN. Immunohistochemical profile displayed strong CK5/6, CK19, p63, EGFR, vimentin, and evident CK14 expression and absence of expression of CK7, chromogranin, synaptophysin, and BRCA1. A high Ki-67 index and p53 expression were noted. Sequencing of the most frequent 46 oncogenes with ionTorrent (AmpliSeq PCR) method identified PIK3CA, KRAS, and TP53 genes as drivers and variants of the FGFR3, PDGFRA, KIT, KDR, EGFR, RET, and ATM genes. The tumor we report displays histo- pathological appearances similar to the previously described case and a genomic landscape fitting to the general population of pancreatic carcinomas. We hypothesize that this tumor may belong to the group of DNA damage repair-deficient pancre- atic carcinoma subgroup.

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