# Klimstra 1995: pancreatoblastoma, a clinicopathologic study and review of the literature

Source: https://onco.cc/key-papers/paper-klimstra-pancreatoblastoma-clinicopathologic-study-ajsp-1995/  
OnCo record `paper-klimstra-pancreatoblastoma-clinicopathologic-study-ajsp-1995` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The defining description of pancreatoblastoma, the rare pancreatic cancer of young children: its distinctive mix of enzyme-producing cells and whorled squamoid nests under the microscope, its generally good outlook after complete removal in children, and its more aggressive behaviour in adults.

## Summary

Clinicopathological study of pancreatoblastomas from the Armed Forces Institute of Pathology with a review of the published literature. The tumours were large and mostly arose in the first decade of life, though adult cases occurred; some were associated with Beckwith-Wiedemann syndrome and many produced alpha-fetoprotein.

Histologically the tumours combined acinar differentiation (confirmed by trypsin, chymotrypsin and lipase immunostains) with squamoid nests, and variable neuroendocrine and ductal elements, distinguishing them from acinar cell carcinoma. Complete resection was associated with cure in most children, while adults and patients with metastases fared poorly.

## Fields

- Kind: Key paper
- Last checked: 2026-09-21
- Journal: American Journal of Surgical Pathology
- Year: 1995
- DOI: 10.1097/00000478-199512000-00005
- Authors: Klimstra DS, Wenig BM, Adair CF, Heffess CS.
- Findings: Acinar differentiation with squamoid nests defines the tumour and separates it from acinar cell carcinoma.; Most cases in young children, some with Beckwith-Wiedemann syndrome; alpha-fetoprotein often raised.; Complete resection cures most children; adults and metastatic cases do poorly.
- What it means: Pathologists diagnose pancreatoblastoma by the criteria set out here, and the paper established that the paediatric and adult forms behave differently.
- Caveats: Small consultation series with limited treatment data.; Molecular features (Wnt pathway and 11p alterations) were described later.

## Sources

- Am J Surg Pathol 1995: https://doi.org/10.1097/00000478-199512000-00005
- PubMed: https://pubmed.ncbi.nlm.nih.gov/7503360/

## Connected records

- cancers: [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Pancreatoblastoma](https://onco.cc/cancers/pancreatoblastoma/)

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