Pancreatoblastoma in an older adult

We present a case of pancreatoblastoma in a 61-year-old man. To our knowledge, this is the oldest patient with this tumor to be reported. Originally regarded as a microadenocarcinoma, the tumor was composed of small cells, sometimes in acinar groups with clusters of squamoid cells. It also showed acinar and neuroendocrine features by immunohistochemistry. Staining for trypsin and several neuroendocrine markers was widespread and intense in the smaller, majority-type cells. There was faint staining for some neuroendocrine markers in the larger squamoid cells. By electron microscopy both exocrine secretory and neurosecretory dense core granules were found. Modern methods of immunohistochemistry and greater understanding of rare tumor types allowed reclassification of this tumor.