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Case Reports
. 2016 Dec 1;2(1):75-78.
doi: 10.1089/crpc.2016.0018. eCollection 2016.

Intraductal Papillary Mucinous Neoplasm of the Pancreas Arising in the Setting of an Intermixed Acinar Cell Cystadenoma of the Pancreas: Report of a Rare Case

Benjamin B Scott  1 , Thea P Price  1 , Zachary M Callahan  1 , Justin S Poling  2 , Harish Lavu  1
Affiliations
Case Reports

Intraductal Papillary Mucinous Neoplasm of the Pancreas Arising in the Setting of an Intermixed Acinar Cell Cystadenoma of the Pancreas: Report of a Rare Case

Benjamin B Scott et al. Case Rep Pancreat Cancer. .

Abstract

Background: Synchronous cystic lesions of the pancreas with different pathophysiology in the same patient are a rare occurrence.. Case Presentation: We report the incidental finding of a multicystic lesion within the pancreatic head in a morbidly obese woman during workup for bariatric surgery. The lesion contained an intraductal papillary mucinous neoplasm (IPMN) with high-grade dysplasia within an acinar cell cystadenoma (ACA). ACAs are rare tumors first described in 2002. Conclusion: To date, there have been no published reports of synchronous IPMN within an ACA. This case report intends to increase provider awareness of these lesions as well as highlight the importance of surveillance and careful histological examination of heterogeneous cystic lesions of the pancreas.

Keywords: acinar cell cystadenoma; cystic lesions of the pancreas; intraductal papillary mucinous neoplasm; pancreas.

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Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
MRI of the abdomen of the 53-year-old woman 1 month before surgery reveals a cystic mass in the head of the pancreas (arrow) with distal pancreatic atrophy. Periportal and peripancreatic lymphadenopathy is appreciated.
<b>FIG. 2.</b>
FIG. 2.
Top left: A focus of acinar cystadenoma superiorly abutting a focus of IPMN. Hematoxylin and eosin stain (100 μm); top right: IPMN with focal high-grade dysplasia. Papillae growing into the ducts—classic of IPMN histology (200 μm); bottom left: granular red cytoplasm showing acinar differentiation and a single prominent nucleus (a feature of acinar cells) (20 μm); bottom right: chymotrypsin stain clearly showing brown appearing zymogen granules from acinar cells (20 μm). IPMN, intraductal papillary mucinous neoplasm.
See this image and copyright information in PMC

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