Acinar Cell Carcinoma with Morphological Change in One Month

A 64-year-old man was admitted to our hospital to undergo examination of a pancreatic tumor accompanied by sudden epigastric pain. The tumor had a well-defined oval shape that was mostly less enhanced, with the exception of part of the tumor on the pancreatic head side, on contrast enhanced (CE)-CT....

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Published inInternal Medicine Vol. 60; no. 17; pp. 2799 - 2806
Main Authors Yoshida, Naoki, Kikuta, Kazuhiro, Miura, Shin, Matsumoto, Ryotaro, Furukawa, Toru, Sano, Takanori, Hamada, Shin, Takikawa, Tetsuya, Hata, Tatsuo, Masamune, Atsushi, Tanaka, Yu, Kume, Kiyoshi, Unno, Michiaki, Omori, Yuko, Ikeda, Mio, Hongo, Seiji
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.09.2021
Japan Science and Technology Agency
Subjects
Case Report
ERCP
EUS
Internal medicine
Morphology
Pancreas
pancreatic cancer
pancreatic tumor
EUS
pancreatic cancer
ERCP
pancreatic tumor
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Abstract A 64-year-old man was admitted to our hospital to undergo examination of a pancreatic tumor accompanied by sudden epigastric pain. The tumor had a well-defined oval shape that was mostly less enhanced, with the exception of part of the tumor on the pancreatic head side, on contrast enhanced (CE)-CT. However, CE-CT performed one-month later revealed that the viable part of the tumor grew toward the pancreatic tail with the reduction of necrotic tissue. We performed distal pancreatectomy and the tumor was diagnosed as acinar cell carcinoma (ACC). One important characteristic of ACC is that it may develop morphological changes within a short period of time.
AbstractList A 64-year-old man was admitted to our hospital to undergo examination of a pancreatic tumor accompanied by sudden epigastric pain. The tumor had a well-defined oval shape that was mostly less enhanced, with the exception of part of the tumor on the pancreatic head side, on contrast enhanced (CE)-CT. However, CE-CT performed one-month later revealed that the viable part of the tumor grew toward the pancreatic tail with the reduction of necrotic tissue. We performed distal pancreatectomy and the tumor was diagnosed as acinar cell carcinoma (ACC). One important characteristic of ACC is that it may develop morphological changes within a short period of time.
A 64-year-old man was admitted to our hospital to undergo examination of a pancreatic tumor accompanied by sudden epigastric pain. The tumor had a well-defined oval shape that was mostly less enhanced, with the exception of part of the tumor on the pancreatic head side, on contrast enhanced (CE)-CT. However, CE-CT performed one-month later revealed that the viable part of the tumor grew toward the pancreatic tail with the reduction of necrotic tissue. We performed distal pancreatectomy and the tumor was diagnosed as acinar cell carcinoma (ACC). One important characteristic of ACC is that it may develop morphological changes within a short period of time.A 64-year-old man was admitted to our hospital to undergo examination of a pancreatic tumor accompanied by sudden epigastric pain. The tumor had a well-defined oval shape that was mostly less enhanced, with the exception of part of the tumor on the pancreatic head side, on contrast enhanced (CE)-CT. However, CE-CT performed one-month later revealed that the viable part of the tumor grew toward the pancreatic tail with the reduction of necrotic tissue. We performed distal pancreatectomy and the tumor was diagnosed as acinar cell carcinoma (ACC). One important characteristic of ACC is that it may develop morphological changes within a short period of time.
ArticleNumber 7121-21
Author Tanaka, Yu
Masamune, Atsushi
Sano, Takanori
Takikawa, Tetsuya
Miura, Shin
Omori, Yuko
Ikeda, Mio
Kikuta, Kazuhiro
Hata, Tatsuo
Furukawa, Toru
Yoshida, Naoki
Kume, Kiyoshi
Hamada, Shin
Unno, Michiaki
Hongo, Seiji
Matsumoto, Ryotaro
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  fullname: Miura, Shin
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  fullname: Matsumoto, Ryotaro
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  fullname: Furukawa, Toru
  organization: Department of Investigative Pathology, Tohoku University Graduate School of Medicine, Japan
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  fullname: Sano, Takanori
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  fullname: Omori, Yuko
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  fullname: Hongo, Seiji
  organization: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
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10.2169/internalmedicine.0294-17
10.1007/s12328-017-0777-5
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10.1007/s12328-017-0785-5
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10.1097/PAS.0b013e318263209d
10.1159/000441414
10.2169/internalmedicine.53.2859
10.1016/j.clinimag.2012.06.003
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pancreatic cancer
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pancreatic tumor
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Correspondence to Dr.　Shin Miura, miurashin@med.tohoku.ac.jp
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References 5. Seki M, Natori K, Kishi Y, et al. Early image findings of acinar-endocrine carcinoma of the pancreas: a case report. Suizou 25: 693-701, 2010 (in Japanese, Abstract in English).
8. Kida A, Matsuda K, Takegoshi K, Matsuda M, Sakai A, Noda Y. Pancreatic acinar cell carcinoma with extensive tumor embolism at the trunk of portal vein and pancreatic intraductal infiltration. Clin J Gastroenterol 10: 546-550, 2017.
10. Liu K, Peng W, Zhou Z. The CT findings of pancreatic acinar cell carcinoma in five cases. Clin Imaging 37: 302-307, 2013.
12. Mohammadi A, Porghasem J, Esmaeili A, Ghasemi-Rad M. Spontaneous rupture of a pancreatic acinar cell carcinoma presenting as an acute abdomen. Int J Surg Case Rep 3: 293-295, 2012.
13. Wang Y, Wang S, Zhou X, et al. Acinar cell carcinoma: a report of 19 cases with a brief review of the literature. World J Surg Oncol 14: 172, 2016.
17. Ploquin A, Baldini C, Vuagnat P, Makhloufi S, Desauw C, Hebbar M. Prolonged survival in a patient with a pancreatic acinar cell carcinoma. Case Rep Oncol 8: 447-450, 2015.
7. Hashimoto M, Matsuda M, Watanabe G, et al. Acinar cell carcinoma of the pancreas with intraductal growth: report of a case. Pancreas 26: 306-308, 2003.
1. Kitagami H, Kondo S, Hirano S, Kawakami H, Egawa S, Tanaka M. Acinar cell carcinoma of the pancreas: clinical analysis of 115 patients from Pancreatic Cancer Registry of Japan Pancreas Society. Pancreas 35: 42-6, 2007.
18. Yoshida N, Kanno A, Masamune A, et al. Pancreatic acinar cell carcinoma with multiple liver metastases effectively treated by S-1 chemotherapy. Intern Med 57: 3529-3535, 2018.
4. La Rosa S, Adsay V, Albarello L, et al. Clinicopathologic study of 62 acinar cell carcinomas of the pancreas: insights into the morphology and immunophenotype and search for prognostic markers. Am J Surg Pathol 36: 1782-1795, 2012.
2. Hu S, Hu S, Wang M, Wu Z, Miao F. Clinical and CT imaging features of pancreatic acinar cell carcinoma. Radiol Med 118: 723-731, 2013.
15. Glazer ES, Neill KG, Frakes JM, et al. Systematic review and case series report of acinar cell carcinoma of the pancreas. Cancer Control 23: 446-454, 2016.
6. Brierley JD, Gospodarowicz MK, Wittekind C. TNM Classification of Malignant Tumours. 8th ed. Wiley-Blackwell, Oxford, 2017.
14. Matos JM, Schmidt CM, Turrini O, et al. Pancreatic acinar cell carcinoma: a multi-institutional study. J Gastrointest Surg 13: 1495-1502, 2009.
16. Hashimoto M, Hikichi T, Suzuki T, et al. Successful chemotherapy with modified FOLFIRINOX for pancreatic acinar cell carcinoma. Clin J Gastroenterol 10: 564-569, 2017.
3. Basturk O, Zamboni G, Klimstra DS, et al. Intraductal and papillary variants of acinar cell carcinomas: a new addition to the challenging differential diagnosis of intraductal neoplasms. Am J Surg Pathol 31: 363-370, 2007.
9. Kanno A, Masamune A, Hamada S, et al. Sudden disappearance of the blood flow in a case of pancreatic acinar cell carcinoma. Intern Med 2589-2593, 2014.
11. Inoue K, Hirota M, Kimura Y, Kuwata K, Ohmuraya M, Ogawa M. Further evidence for endothelin as an important mediator of pancreatic and intestinal ischemia in severe acute pancreatitis. Pancreas 26: 218-223, 2003.
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12
13
14
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References_xml – reference: 18. Yoshida N, Kanno A, Masamune A, et al. Pancreatic acinar cell carcinoma with multiple liver metastases effectively treated by S-1 chemotherapy. Intern Med 57: 3529-3535, 2018.
– reference: 7. Hashimoto M, Matsuda M, Watanabe G, et al. Acinar cell carcinoma of the pancreas with intraductal growth: report of a case. Pancreas 26: 306-308, 2003.
– reference: 17. Ploquin A, Baldini C, Vuagnat P, Makhloufi S, Desauw C, Hebbar M. Prolonged survival in a patient with a pancreatic acinar cell carcinoma. Case Rep Oncol 8: 447-450, 2015.
– reference: 13. Wang Y, Wang S, Zhou X, et al. Acinar cell carcinoma: a report of 19 cases with a brief review of the literature. World J Surg Oncol 14: 172, 2016.
– reference: 10. Liu K, Peng W, Zhou Z. The CT findings of pancreatic acinar cell carcinoma in five cases. Clin Imaging 37: 302-307, 2013.
– reference: 2. Hu S, Hu S, Wang M, Wu Z, Miao F. Clinical and CT imaging features of pancreatic acinar cell carcinoma. Radiol Med 118: 723-731, 2013.
– reference: 4. La Rosa S, Adsay V, Albarello L, et al. Clinicopathologic study of 62 acinar cell carcinomas of the pancreas: insights into the morphology and immunophenotype and search for prognostic markers. Am J Surg Pathol 36: 1782-1795, 2012.
– reference: 6. Brierley JD, Gospodarowicz MK, Wittekind C. TNM Classification of Malignant Tumours. 8th ed. Wiley-Blackwell, Oxford, 2017.
– reference: 8. Kida A, Matsuda K, Takegoshi K, Matsuda M, Sakai A, Noda Y. Pancreatic acinar cell carcinoma with extensive tumor embolism at the trunk of portal vein and pancreatic intraductal infiltration. Clin J Gastroenterol 10: 546-550, 2017.
– reference: 11. Inoue K, Hirota M, Kimura Y, Kuwata K, Ohmuraya M, Ogawa M. Further evidence for endothelin as an important mediator of pancreatic and intestinal ischemia in severe acute pancreatitis. Pancreas 26: 218-223, 2003.
– reference: 15. Glazer ES, Neill KG, Frakes JM, et al. Systematic review and case series report of acinar cell carcinoma of the pancreas. Cancer Control 23: 446-454, 2016.
– reference: 16. Hashimoto M, Hikichi T, Suzuki T, et al. Successful chemotherapy with modified FOLFIRINOX for pancreatic acinar cell carcinoma. Clin J Gastroenterol 10: 564-569, 2017.
– reference: 9. Kanno A, Masamune A, Hamada S, et al. Sudden disappearance of the blood flow in a case of pancreatic acinar cell carcinoma. Intern Med 2589-2593, 2014.
– reference: 12. Mohammadi A, Porghasem J, Esmaeili A, Ghasemi-Rad M. Spontaneous rupture of a pancreatic acinar cell carcinoma presenting as an acute abdomen. Int J Surg Case Rep 3: 293-295, 2012.
– reference: 1. Kitagami H, Kondo S, Hirano S, Kawakami H, Egawa S, Tanaka M. Acinar cell carcinoma of the pancreas: clinical analysis of 115 patients from Pancreatic Cancer Registry of Japan Pancreas Society. Pancreas 35: 42-6, 2007.
– reference: 3. Basturk O, Zamboni G, Klimstra DS, et al. Intraductal and papillary variants of acinar cell carcinomas: a new addition to the challenging differential diagnosis of intraductal neoplasms. Am J Surg Pathol 31: 363-370, 2007.
– reference: 14. Matos JM, Schmidt CM, Turrini O, et al. Pancreatic acinar cell carcinoma: a multi-institutional study. J Gastrointest Surg 13: 1495-1502, 2009.
– reference: 5. Seki M, Natori K, Kishi Y, et al. Early image findings of acinar-endocrine carcinoma of the pancreas: a case report. Suizou 25: 693-701, 2010 (in Japanese, Abstract in English).
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Morphology
Pancreas
pancreatic cancer
pancreatic tumor
Title Acinar Cell Carcinoma with Morphological Change in One Month
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