Combined osteoclastic giant cell and pleomorphic giant cell tumor of the pancreas: a rarity. An immunohistochemical analysis and review of the literature.

CONTEXT: The combination of an osteoclastic giant cell tumor and a pleomorphic giant cell carcinoma of the pancreas is distinctly unusual and is associated with an adverse outcome. The origin of these two components within a tumor has long been debated based on the immunohistochemical and ultra-structural analysis. CASE REPORT: Herein we describe a tumor with amalgamation of these two distinct histomorphologies along with a minute focus of well-differentiated ductal adenocarcinoma (on multiple sections) in a 50-year male. On immunohistochemical analysis, osteoclastic giant cells were reactive for CD68 and vimentin confirming histiocytic/mesenchymal derivation whereas pleomorphic giant cells and mononuclear cells were reactive for cytokeratin which proved their epithelial nature. CONCLUSIONS: Although the present case had an equal proportion of both components, it is very important to correctly assess the predominant histology since osteoclastic giant cell tumor has a better prognosis as compared to the more aggressive pleomorphic giant cell carcinoma component.

Plasmacytoma of the rib in young male.

Solitary plasmacytoma of the 11th rib with soft tissue extension was seen in a 29-year-old male. Hematological and biochemical profiles did not reveal any systemic involvement. The 12-cm fusiform expansile lesion was excised and subjected to histopathological examination. The sections revealed sheets of plasma cells with focal cortical discontinuity and adjacent soft tissue invasion. This case is unique in view of the age of occurrence and the site of the lesion.