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. 2002;4(2):87-90.
doi: 10.1080/136518202760378452.

Acinar cell carcinoma of the pancreas with and without endocrine differentiation

I T Virlos  1 , I M Papazachariou, R C N Wiliamson
Affiliations

Acinar cell carcinoma of the pancreas with and without endocrine differentiation

I T Virlos et al. HPB (Oxford). 2002.

Abstract

Background: Acinar cell carcinoma (ACC) is a rare pancreatic neoplasm, representing 1% of exocrine tumours and containing a variable endocrine component. Three recent cases of ACC are reported.

Case outlines: A 72-year-old man with painless obstructive jaundice had a 5-cm mass in the head of pancreas resected by Whipple's operation; histopathological examination showed a typical ACC. A 33-year-old man with weight loss and abnormal liver function had a dilated biliary tree but no mass on imaging. Pylorus-preserving pancreatoduodenectomy was performed, and histology showed a mixed acinar-neuro-endocrine tumour. A 56-year-old man with weight loss and a palpable mass had a 15-cm mass in the distal body of pancreas, which was resected en bloc with the spleen and adherent stomach; it was a cystic ACC.

Results: Two patients are alive and free of disease at 30 months and 15 months, while the third patient with locally advanced disease died of myocardial infarction at 9 weeks.

Discussion: Acinar structures are the hallmark of this neoplasm, which carries a better survival rate than ductal cancer. Surgical excision prolongs survival and offers the best chance of cure.

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Figures

Figure 1.
Figure 1.
Case no. 1. Late phase coeliac arteriogram showing an obvious tumour ‘blush’ in the head of the pancreas and the adjacent endoscopic stent (arrow).
Figure 2.
Figure 2.
Case no. 2. Endoscopic retrograde cholangiogram showing a low common bile duct stricture.
See this image and copyright information in PMC

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