Skip to main content


Log in

Small cell carcinoma of the pancreas: role of EUS-FNA and subsequent effective chemotherapy using carboplatin and etoposide

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript



Small cell carcinoma (SCC) of the pancreas is a rare entity, with only a few cases reported in the literature. The aim of this study was to evaluate the effectiveness of combination chemotherapy with carboplatin and etoposide (CE) in SCC of the pancreas.


We performed a retrospective analysis of four patients diagnosed with SCC among 279 patients with malignant pancreatic tumors treated between 2000 and 2007. All patients were treated with combination chemotherapy using a schedule consisting of intravenous (IV) carboplatin (150 mg/m2) on day 1 and IV etoposide (80 mg/m2) on days 1, 2, and 3 every 28 days.


Pathological diagnosis was confirmed by endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) in all patients. Three patients treated with the combination chemotherapy achieved remission, two with a complete response and one with a partial response. The remaining one patient showed no change. One of the two patients with a complete response survived for 56 months following the diagnosis.


Combination chemotherapy with CE may be effective for the treatment of SCC of the pancreas; EUS-FNA plays an important role in distinguishing SCC from other pancreatic malignancies, leading to the appropriate treatment being given.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others


  1. Neugut AI, Sherr D, Robinson E, Murrav T, Nieves J. Differences in histology between first and second primary lung cancer. Cancer Epidemiol Biomarkers Prev. 1992;1:109–12.

    PubMed  CAS  Google Scholar 

  2. Percy C, Sabin L. Survelliance, epidemiology and end-results lung cancer data applied to the World Health Organization classification of lung tumors. J Natl Cancer Inst. 1983;70:663–6.

    PubMed  CAS  Google Scholar 

  3. Reyes CV, Wang T. Undifferentiated small cell carcinoma of the pancreas: a report of five cases. Cancer. 1981;47:2500–2.

    Article  PubMed  CAS  Google Scholar 

  4. Wahid NA, Neugut AI, Hibshoosh H, Brunetti JC, Fountain KS, Rubin M. Response of small cell carcinoma of pancreas to a small cell lung cancer regimen: a case report. Cancer Invest. 1996;14:335–9.

    Article  PubMed  CAS  Google Scholar 

  5. Morant R, Bruckner HW. Complete remission of refractory small cell carcinoma of the pancreas with cisplatin and etoposide. Cancer. 1989;64:2007–9.

    Article  PubMed  CAS  Google Scholar 

  6. Kajikawa M, Kondo K, Kataoka M, Hatsuno T, Kinoshita M, Horisawa M, et al. A case of endocrine cell carcinoma (small cell carcinoma) of duodenum. Nippon Shokakibyo Gakkai Zasshi. 2006;103:523–8.

    PubMed  Google Scholar 

  7. Berkel S, Hummel F, Gaa J, Back W, Hofheinz R, Queisser W, et al. Poorly differentiated small cell carcinoma of the pancreas. A case report and review of the literature. Pancreatology. 2004;4:521–6.

    Article  PubMed  Google Scholar 

  8. Tanaka K, Fujiwara M, Kondoh H, Konisi T, Itou Y. A case of small cell carcinoma of the pancreas. Nippon Shokakibyo Gakkai Zasshi. 2001;98:668–74.

    PubMed  CAS  Google Scholar 

  9. Tokuhiro N, Suzuki Y, Fukazawa T, Kinosita S, Nishiguchi H, Yoshida S, et al. A case of small cell carcinoma of the pancreas, response to the modified CHOP therapy. Nippon Shokakibyo Gakkai Zasshi. 1993;90:2162–7.

    PubMed  CAS  Google Scholar 

  10. World Health Organization: The World Health Organization histological typing of lung tumor. Am J Clin Pathol 1982; 77:123–136.

    Google Scholar 

  11. World Health Organization. WHO Handbook for reporting results of cancer treatment (who offset publication no. 48). Geneva, Switzerland: World Health Organization; 1979.

  12. Miller JR, Baggentoss AH, Comfort MW. Carcinoma of the pancreas: effect of histological type and grade of malignancy on its behavior. Cancer 195;4:233–4.

  13. O’Connor TP, Wade TP, Sunwoo YC, Reimers HJ, Palmer DC, Silverrq AB, et al. Small cell undifferentiated carcinoma of the pancreas. Report of a patient with tumor marker studies. Cancer. 1992;70:1514–9.

    Article  PubMed  Google Scholar 

  14. Motojima K, Furui J, Terada M, Shioqama T, Kohara N, Tsunoda T, et al. Small cell carcinoma of the pancreas and biliary tract. J Surg Oncol. 1990;45:164–8.

    Article  PubMed  CAS  Google Scholar 

  15. Hobbs RD, Stewart AF, Ravin ND, Carter D. Hypercalcemia in small cell carcinoma of the pancreas. Cancer. 1984;53:1552–4.

    Article  PubMed  CAS  Google Scholar 

  16. Cheity R, Clark P, Pitson A. Primary small cell carcinoma of the pancreas. Pathology. 1993;25:240–2.

    Article  Google Scholar 

  17. Sandler M, Rubin PC, Reid JL, Smith GD. Oat cell carcinoma in the pancreas: an unusual cause of Cushing’s syndrome. Br J Hosp Med. 1992;47:537–8.

    PubMed  CAS  Google Scholar 

  18. Morikawa T, Kobayashi S, Yamadori I, Okino T, Hirakawa E, Kurose A, et al. Three cases of extrapulmonary small cell carcinoma occurring in the prostate, stomach, and pancreas. Indian J Cancer. 1994;31:268–73.

    PubMed  CAS  Google Scholar 

  19. Namieno T, Koito K, Nagakawa T, Morita K, Uchino J. Diagnostic features on images in primary small cell carcinoma of the pancreas. Am J Gastroenterol. 1997;92:319–22.

    PubMed  CAS  Google Scholar 

  20. Wang RF, Chou YH, Hwang JI, Tiu CM, Chiou HJ, Chen SP, et al. Primary small cell carcinoma of the pancreas with an unusual sonographic appearance. J Clin Ultrasound. 2007;35:82–4.

    Article  PubMed  CAS  Google Scholar 

  21. Ichikawa T, Federle MP, Ohba S, Ohtomo K, Suqiyama A, Fujimoto H, et al. Atypical exocrine and endocrine pancreatic tumors (anaplastic, small cell, and giant cell types): CT and pathologic features in 14 patients. Abdom Imaging. 2000;25:409–19.

    Article  PubMed  CAS  Google Scholar 

  22. Corrin B, Path MRC, Gilby ED, Patrick J. Oat cell carcinoma of the pancreas with ectopic ACTH secretion. Cancer. 1973;31:1523–7.

    Article  PubMed  CAS  Google Scholar 

  23. Pathchefsky AS, Solit R, Phillips LD, Craddock M, Harrer MV, Cohn HE, et al. Hydroxyindole-producing tumors of the pancreas; carcinoid-islet cell tumor and oat cell carcinoma. Ann Intern Med. 1972;77:53–61.

    Google Scholar 

  24. Bishop JF, Raghanvan D, Stuart-Harris R, Morstyn G, Aroney R, Kefford R, et al. Carboplatin (CBDCA, JM-8) and VP-16-213 in previously untreated patients with small-cell lung cancer. J Clin Oncol. 1987;5:1574–8.

    PubMed  CAS  Google Scholar 

  25. Smith IE, Evans BD, Gore ME, et al. Carboplatin (paraplatin: JM-8) and etoposide (VP-16) as a first-line combination therapy for small-cell lung cancer. J Clin Oncol. 1987;5:185–9.

    PubMed  CAS  Google Scholar 

  26. Carney DN. Carboplatin/etoposide combination chemotherapy in the treatment of poor prognosis patients with small cell lung cancer. Lung Cancer. 1995;12(Suppl 3):S22–83.

    Google Scholar 

  27. Evans WK, Eisenhaur E, Hughes P, Maroun JA, Ayoub J, Shepherd FA, et al. VP-16 and carboplatin in previously untreated patients with extensive small cell lung cancer: a study of the National Cancer Institute of Canada Clinical Trial Group. Br J Cancer. 1988;58:464–8.

    PubMed  CAS  Google Scholar 

  28. Skarlos DV, Samantas E, Kosmidis P, Fountzlilas G, Anqelidou M, Palamidas P, et al. Randomized comparison of etoposide–cisplatin vs etoposide–carboplatin and irradiation in small-cell lung cancer: a Hellenic Co-operative Oncology Group study. Ann Oncol. 1994;5:601–7.

    PubMed  CAS  Google Scholar 

  29. Vilmann P, Jacobesen GK, Henriksen FW, Hancke S. Endoscopic ultrasonography with guided fine needle aspiration biopsy in pancreatic disease. Gastrointest Endosc. 1992;38:172–3.

    Article  PubMed  CAS  Google Scholar 

  30. Wiersema MJ, Vilmann P, Giovannini M, Chang KJ, Wiersema LM. Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology. 1997;112:1087–95.

    Article  PubMed  CAS  Google Scholar 

  31. Lai R, Stanley MW, Bardales R, Linzie B, Mallery S. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis of digestive disease. Endoscopy. 2002;34:715–20.

    Article  PubMed  CAS  Google Scholar 

  32. Chang KJ, Nguyen P, Erickson RA, Durbin TE, Katz KD. The clinical utility of endoscopic ultrasound-guided fine needle aspiration in the diagnosis and staging of pancreatic carcinoma. Gastrointest Endosc. 1997;45:387–93.

    Article  PubMed  CAS  Google Scholar 

  33. Bhutani MS, Hawes RH, Baron PL, Sanders-Ciette, van Velse A, Obborne JF, et al. Endoscopic-ultrasound fine needle aspiration of malignant pancreatic lesion. Endoscopy 1997; 29: 854–8.

  34. Giovannini M, Seitz JF, Monges G, Perrier H, Rabbia T. Fine-needle aspiration cytology guided by endoscopic ultrasonography: results in 141 patients. Endoscopy. 1995;27:171–7.

    Article  PubMed  CAS  Google Scholar 

  35. Sakamoto H, Kitano M, Suetomi Y, Maekawa K, Takeyama Y, Kudo M. Utility of contrast-enhanced endoscopic ultrasonography for diagnosis of small pancreatic carcinomas. Ultrasound Med Biol. 2008;34:525–31.

    Article  PubMed  Google Scholar 

  36. Kitano M, Sakamoto H, Matsui U, Ito Y, Maekawa K, von Schrenck T, et al. A novel perfusion imaging technique of the pancreas: contrast-enhanced harmonic EUS (with video). Gastrointest Endosc. 2008;67:141–50.

    Article  PubMed  Google Scholar 

Download references


The present study was supported by grants from the Japan Society for Promotion of Science.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Masayuki Kitano.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sakamoto, H., Kitano, M., Komaki, T. et al. Small cell carcinoma of the pancreas: role of EUS-FNA and subsequent effective chemotherapy using carboplatin and etoposide. J Gastroenterol 44, 432–438 (2009).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: