{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:54:46Z","timestamp":1789232086645,"version":"build-2803163510"},"reference-count":9,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Anaplastic pancreatic carcinoma (APC) arising from mucinous cystic neoplasm (MCN) is rare, with only 12 cases reported. The relationship between pregnancy\u2010associaed hormonal changes and MCN progression remains poorly understood, particularly regarding hormone receptor expression patterns during malignant transformation. A 34\u2010year\u2010old woman presented with persistent abdominal pain 9 months post\u2010delivery. Imaging revealed an 11\u2009cm multilocular cystic mass in the pancreatic body and tail with mural nodules showing blood flow signals. Laboratory findings demonstrated normal. She underwent distal pancreatectomy and splenectomy and no recurrence at 6\u2010month follow\u2010up. Histopathological examination revealed MCN with ovarian\u2010type stroma progressing from low\u2010to\u2010high grade dysplasia, invasive ductal carcinoma, and anaplastic carcinoma with osteoclast\u2010like giant cells. Immunohistochemically, estrogen receptor (ER) expression showed stepwise pattern: negative in low\u2010grade dysplasia, strongly positive in high\u2010grade dysplasia and anaplastic components. Progesterone receptor positivity was observed in stromal and epithelial components, with elevated Ki\u201067 correlating with ER expression. This represents first documentation of progressive ER acquisition during MCN malignant transformation, suggesting autonomous hormone production by ovarian\u2011type stroma may help sustain tumor growth beyond pregnancy. Stepwise ER expression may serve as a biomarker for risk stratification and a potential target for therapy in hormone\u2010sensitive pancreatic neoplasms.<\/jats:p>","DOI":"10.1111\/pin.70061","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T13:47:12Z","timestamp":1761659232000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Progressive Estrogen Receptor Acquisition During Malignant Transformation: Insights From MCN\u2010Derived Anaplastic Pancreatic Carcinoma"],"prefix":"10.1111","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5097-3538","authenticated-orcid":false,"given":"Kei","family":"Kono","sequence":"first","affiliation":[{"name":"Department of Diagnostic Pathology Toranomon Hospital Tokyo Japan"},{"name":"Okinaka Memorial Institute for Medical Research Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1277-1186","authenticated-orcid":false,"given":"Ryo","family":"Shibayama","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5119-4982","authenticated-orcid":false,"given":"Hisashi","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3157-1055","authenticated-orcid":false,"given":"Tomohiko","family":"Masumoto","sequence":"additional","affiliation":[{"name":"Okinaka Memorial Institute for Medical Research Tokyo Japan"},{"name":"Department of Diagnostic Radiology Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2101-0163","authenticated-orcid":false,"given":"Kosuke","family":"Maehara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3021-2579","authenticated-orcid":false,"given":"Tsunao","family":"Imamura","sequence":"additional","affiliation":[{"name":"Okinaka Memorial Institute for Medical Research Tokyo Japan"},{"name":"Department of Gastroenterology Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4176-3851","authenticated-orcid":false,"given":"Satoshi","family":"Okubo","sequence":"additional","affiliation":[{"name":"Okinaka Memorial Institute for Medical Research Tokyo Japan"},{"name":"Department of Gastrointestinal Surgery Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0616-3348","authenticated-orcid":false,"given":"Masaji","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Okinaka Memorial Institute for Medical Research Tokyo Japan"},{"name":"Department of Gastrointestinal Surgery Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7237-1183","authenticated-orcid":false,"given":"Takeshi","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Toranomon Hospital Tokyo Japan"},{"name":"Okinaka Memorial Institute for Medical Research Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Takazawa","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Toranomon Hospital Tokyo Japan"},{"name":"Okinaka Memorial Institute for Medical Research Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2014.08.007"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.132"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/pancan.2017.0004"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-011-1797-y"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2024.02.002"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2010.04.026"},{"key":"e_1_2_9_8_1","first-page":"3622","article-title":"ERR\u03b1 Promotes Pancreatic Cancer Progression by Enhancing the Transcription of PAI1 and Activating the MEK\/ERK Pathway","volume":"10","author":"Liu S. L.","year":"2020","journal-title":"American Journal of Cancer Research"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.7252"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2012.09.022"}],"container-title":["Pathology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pin.70061","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pin.70061","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pin.70061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T05:56:20Z","timestamp":1769666180000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pin.70061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,28]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/pin.70061"],"URL":"https:\/\/doi.org\/10.1111\/pin.70061","archive":["Portico"],"relation":{},"ISSN":["1320-5463","1440-1827"],"issn-type":[{"value":"1320-5463","type":"print"},{"value":"1440-1827","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,28]]},"assertion":[{"value":"2025-06-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70061"}}