Peri-ampullary mixed acinar-endocrine carcinoma

Abstract

Mixed acinar-endocrine carcinomas (MAEC) are rare tumors of the pancreas. We present the case of a patient with periampullary tumor that presented with painless jaundice and after investigation was found to have MAEC. He underwent pancreaticoduo-dunectomy with tumor free margins and negative lymph nodes. The patient presented with local recurrence and liver metastasis after 1 year and is on chemotherapy with stable lesions 30 months after the diagnosis.

Keywords: mixed acinar-endocrine carcinoma; pancreas; tumor..

Figure 1

Histological sections of the resected mass. (1) Low magnification showing tumor extending into duodenal mucosa. (H&E, 20×). (2) Higher magnification showing the acinar exocrine component of the tumor (left) and endocrine component (right). (H&E, 100×). (3) The exocrine component consists of well differentiated cells arranged in acini. (H&E, 400×). (4) Portion of the endocrine component showing nests of tumor cells with chromogranin A positivity (400×).

Figure 2

Computed tomography scan of the abdomen showing the recurrent lesions. (1) The liver lesions that were detected on computed tomography scan. (2) The recurrent mass in the left paraaortic region. (3) Latest image of the liver lesions that show regression in size after the treatment in comparison to 1st image. (4) Regression of the mass in the primary site of the neoplasm.