A yolk sac tumor of the pancreas and derived xenograft model effectively responded to VIP chemotherapy

Pancreatology. 2020 Apr;20(3):551-557. doi: 10.1016/j.pan.2019.12.021. Epub 2019 Dec 31.

Abstract

Background: Yolk sac tumors (YSTs) of the pancreas are extremely rare, and no drug responsiveness data are available regarding YSTs.

Methods: We report a pancreatic YST in a 70-year-old woman, and its chemotherapeutic responsiveness based on clinical records and evaluation of a patient-derived xenograft (PDX) line of the YST.

Results: The YST was an 11-cm, solid mass located in the pancreatic tail. Histologically, the tumor showed medullary proliferation of tumor cells, with a variety of growth patterns including microcystic/reticular, endodermal sinus, and hepatoid patterns. Immunohistochemically, the tumor cells were positive for Sall4, glypican-3, and alpha-fetoprotein. We administered VIP (etoposide, ifosfamide, cisplatin) chemotherapy for a recurrent liver tumor, and obtained complete pathological remission. A drug-response assay using the PDX line from this YST revealed that both VIP and gemcitabine effectively inhibit tumor growth.

Conclusions: These results suggest that differential diagnosis of YST from adenocarcinoma is important for selecting appropriate chemotherapy.

Keywords: Pancreas cancer; Patient-derived xenograft.

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / drug therapy
  • Aged
  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cell Line, Tumor
  • Cisplatin / therapeutic use
  • Diagnosis, Differential
  • Endodermal Sinus Tumor / drug therapy*
  • Female
  • Humans
  • Ifosfamide / therapeutic use
  • Liver Neoplasms / complications
  • Liver Neoplasms / drug therapy
  • Mice
  • Pancreatic Neoplasms / drug therapy*
  • Vindesine / therapeutic use
  • Xenograft Model Antitumor Assays

Substances

  • Cisplatin
  • Vindesine
  • Ifosfamide

Supplementary concepts

  • VIP protocol 3