Mixed Acinar-Endocrine Carcinoma of the Pancreas with Intraductal Growth into the Main Pancreatic Duct : Report of a Case

• Published in: Surgery today (Tokyo, Japan) Vol. 40; no. 4; pp. 380 - 384
• Main Authors: Kobayashi, Shinjiro, Asakura, Takeshi, Ohike, Nobuyuki, Enomoto, Takeharu, Sakurai, Joe, Koizumi, Satoshi, Watanabe, Taiji, Nakano, Hiroshi, Otsubo, Takehito
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.04.2010
• Subjects: Aged; Biomarkers - analysis; Carcinoma, Acinar Cell - pathology; Case Report; Cholangiopancreatography, Endoscopic Retrograde; Chromogranin A - analysis; Endocrine Gland Neoplasms - pathology; Humans; Intraductal growth; Male; Medicine; Medicine & Public Health; Mixed acinar-endocrine carcinoma; Pancreatic cancer; Pancreatic Ducts - pathology; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - pathology; Surgery; Surgical Oncology; Tomography, X-Ray Computed; Pancreatic cancer; Mixed acinar-endocrine carcinoma; Intraductal growth
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-009-4083-9

The patient was a 75-year-old asymptomatic man, in whom a tumor mass in the pancreatic tail had been found 6 months earlier. Computed tomography revealed a mass 7 cm in diameter, and an enhancement with contrast medium was observed at the periphery and partially inside the mass, but not in most parts of the tumor. Endoscopic retrograde cholangiopancreatography showed a filling defect in the main pancreatic duct. A distal pancreatectomy was performed because of the possibility of a malignant tumor. The tumor consisted of a lobular invasive growth component and a component with intraductal growth into the main pancreatic duct, and histologically the tumor cells had solid acinar to partially trabecular/tubular patterns. Trypsin (an acinic cell marker) expression was widely observed, followed by the expression of chromogranin A (an endocrine cell marker) in about 30% of the tumor cells. The tumor was diagnosed as mixed acinar-endocrine carcinoma according to the WHO classification.