Original Paper

Is Serous Cystadenoma of the Pancreas a Model of Clear-Cell-Associated Angiogenesis and Tumorigenesis?
Duangpen Thirabanjasak^a, Olca Basturk^b, Deniz Altinel^c, Jeanette D. Cheng^d, N. Volkan Adsay^c

Departments of Pathology,
^aWayne State University and Karmanos Cancer Institute, Detroit, Mich.,
^bNew York University, New York, N.Y.,
^cEmory University and Winship Cancer Institute, and
^dPiedmont Hospital, Atlanta, Ga., USA

Address of Corresponding Author

Pancreatology 2009;9:182-188 (DOI: 10.1159/000178890)

  Key Words

• Pancreas
• Serous cystadenoma
• Angiogenesis
• Clear cell

  Abstract

Background: Similar to the other von Hippel-Lindau (VHL)-related tumors such as renal cell carcinomas and capillary hemangioblastomas, serous cystadenomas (SCAs) of the pancreas are also characterized by clear cells. Over the years, we have also noticed that the tumor epithelium shows a prominent capillary network. Methods: Eighteen cases of SCA were reviewed histologically, and immunohistochemical analysis was performed for CD31 and vascular endothelial growth factor (VEGF) as well as the molecules implicated in clear-cell tumorigenesis: GLUT-1, hypoxia-inducible factor-1 (HIF-1), and carbonic anhydrase IX (CA IX). Results: There was an extensively rich capillary network that appears almost intraepithelially in all cases of SCA, which was confirmed by CD31 stain that showed, on average, 26 capillaries per every 100 epithelial cells. VEGF expression was identified in 10/18 cases. Among the clear-cell tumorigenesis markers, CA IX was detected in all cases, GLUT-1 and HIF-1 in most cases. Conclusion: As in other VHL-related clear-cell tumors, there is a prominent capillary network immediately adjacent to the epithelium of SCA, confirming that the clear-cell- angiogenesis association is also valid for this tumor type. Molecules implicated in clear-cell tumorigenesis are also consistently expressed in SCA. This may have biologic and therapeutic implications, especially considering the rapidly evolving drugs against these pathways. More importantly, SCA may also serve as a model of clear-cell-associated angiogenesis and tumorigenesis, and the information gained from this tumor type may also be applicable to other clear-cell tumors.

Copyright © 2008 S. Karger AG, Basel and IAP

  Author Contacts

N. Volkan Adsay, MD
Emory University Hospital and Winship Cancer Institute
Department of Pathology, Room H-185-B
1364 Clifton Road NE, Atlanta, GA 30322 (USA)
Tel. +1 404 712 4179, Fax +1 404 712 8802, E-Mail volkan.adsay@emory.edu

  Article Information

Received: December 31, 2007
Accepted after revision: July 2, 2008
Published online: December 13, 2008
Number of Print Pages : 7
Number of Figures : 7, Number of Tables : 2, Number of References : 46