부산대학교 도서관

A 78-year-old woman was taken to a local hospital for hematemesis. A tumor of about 50 mm on the papillary side of the descending duodenum with strong contrast at the periphery and low density inside was observed on contrast-enhanced CT. The interior of the tumor was connected to the duodenum. Esophagogastroduodenoscopy revealed bleeding from a ruptured tumor, and hemostasis via endoscopy was difficult; thus, the patient was referred for additional treatment. Vital signs were stable at the time of arrival; however, hematemesis and anemia were observed; thus, TAE was performed urgently. After TAE, the patient’s condition stabilized and hematemesis disappeared. We suspected that the hemorrhage was from a submucosal tumor in the duodenum. On the fifth hospital day, subtotal stomach-preserving pancreaticoduodenectomy was performed because of slow, progressive anemia and obstructive jaundice. The tumor was well defined with internal hemorrhagic necrosis. The histopathological diagnosis was anaplastic carcinoma with osteoclast-like giant cells. We report this case as a rare example of anaplastic carcinoma of the pancreas presenting with gastrointestinal bleeding, and we include a review of 102 cases of anaplastic carcinoma of the pancreas reported in Japan.