Ruptured Anaplastic Pancreatic Carcinoma With Liver Metastasis: A Case Report
Bibliographic record
Abstract
A 65-year-old female with no relevant medical history visited our hospital with complaints of general fatigue and unlocalized abdominal pain. Non-contrast computed tomography revealed a tumor in the pancreatic tail, a diffusely swollen liver with obtuse vessel structure, and ascites above the liver surface and around the gallbladder. She went into cardiac arrest immediately after admission for further investigation of the tumor. Despite cardiopulmonary resuscitation, her spontaneous circulation could not be restored. An autopsy conducted with the consent of her family revealed 2,000 mL hemorrhagic ascites in the peritoneal cavity, a tumor measuring 4 × 2 × 2 cm in the pancreatic tail, accompanied by bleeding, and multiple sponge-like liver metastases. Microscopic examination of the pancreatic tumor and liver metastases revealed proliferation of sarcomatoid atypical cells (comprising spindle, pleomorphic, and giant cells) accompanied by red blood cells, necrosis, and fibrosis. Immunohistochemistry staining of the tumor was positive for cytokeratin (CK) AE1/AE3 and CK 7 and negative for CK 20. Thus, a diagnosis of anaplastic pancreatic carcinoma (APC), pleomorphic type, was established. From the autopsy findings, her death was concluded to be due to a hemorrhagic shock resulting from the ruptured APC. APC is a rare carcinoma among pancreatic malignancies and has a poor prognosis with rapid proliferation. Here we present an autopsy case of APC with multiple liver metastases where APC ruptured in the intraperitoneal cavity. J Med Cases. 2017;8(5):141-144 doi: https://doi.org/10.14740/jmc2802w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".