Adenosquamous Carcinoma of the Pancreas That Had Penetrated Into the Stomach and Transverse Colon: A Case Report
Bibliographic record
Abstract
We report the case of pancreatic adenosquamous carcinoma (PASC) that had penetrated into the stomach and transverse colon. A 55-year-old male presented to our hospital with general fatigue, melena, and left flank pain. He had no relevant medical history. A laboratory analysis upon arrival revealed marked anemia with a red blood cell count of 13.3 × 10 4 /uL and a hemoglobin level of 3.6 g/dL. There was tenderness over the upper abdomen and a palpable mass on his left upper abdomen. He was admitted for further examination of his severe anemia and abdominal symptoms. Contrast-enhanced computed tomography revealed multiple liver masses and a 10 cm sized tumor in the pancreas tail involving the gastric wall and transverse colon. Upper gastroendoscopy revealed a 4 cm sized elevated tumor with a central depression in the greater curvature of the middle gastric body. Colonoscopy revealed an ulcerative tumor extending from the splenic flexure to the mid transverse colon. Endoscopic biopsied specimens revealed adenosquamous cell carcinoma. From these findings, the diagnosis of PASC in the pancreatic tail invading into the stomach and transverse colon at an advanced stage IV was established. His anemia was treated by the administration of red blood cell concentration (RCC). Although chemotherapy was planned after his malnutrition improved, his circulatory condition worsened on day 20. Despite 10 units of RCC, his anemia did not improve and he died from circulatory insufficiency on day 23. An autopsy revealed PASC in the pancreas tail measuring 14 cm that had penetrated into the gastric wall and transverse colon. A massive amount of blood was discovered in the stomach. His death was caused by massive bleeding from the invaded lesions of the stomach. Adenosquamous carcinoma, consisting of adenocarcinoma and squamous cell carcinoma, is characterized by its aggressive proliferation and poor prognosis. To date, consensuses in the management of PASC have not been established. Further accumulation of knowledge about this carcinoma is required. J Med Cases. 2017;8(1):24-28 doi: https://doi.org/10.14740/jmc2723w
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".