J Korean Surg Soc.  2010 Oct;79(4):310-315. 10.4174/jkss.2010.79.4.310.

Acinar Cell Carcinoma of the Pancreas: A Report of Two Cases with Long-term Follow-up and a Review of the Literature

• Lee JH
• Lee KG
• Oh YH
• Paik SS
• Park HK
• Lee KS

• KMID: 2145035
• DOI: http://doi.org/10.4174/jkss.2010.79.4.310

Abstract

Acinar cell carcinoma (ACC) of the pancreas is a rare malignancy making up approximately 1% of pancreatic non-endocrine malignant tumors. The common finding on computed tomography is a solitary, well-defined, heterogenous hypodense mass with enhancing capsule. ACC is a highly cellular tumor with minimal stroma and a lack of stromal desmoplasia. The accurate diagnosis of ACC cannot typically be done by histology alone but rather requires immunohistochemical staining or electron microscopy for the identification of pancreatic enzymes and zymogen granules. ACC has been considered a cancer with a poor prognosis due to frequent metastasis, a high recurrence rate, and low respectability. Surgical resection is the treatment of choice that can lead to long-term survival. ACC has a better prognosis than ductal carcinoma of the pancreas, but a worse prognosis compared to islet cell carcinoma. We report two cases of ACC with 5-year survival after surgical resection.

Keyword

Acinar cell carcinoma; Pancreas

MeSH Terms

Acinar Cells
Carcinoma, Acinar Cell
Carcinoma, Islet Cell
Carcinoma, Pancreatic Ductal
Follow-Up Studies
Microscopy, Electron
Neoplasm Metastasis
Pancreas
Prognosis
Recurrence
Secretory Vesicles

Figure

• 

  Fig. 1 (A) Contrast-enhanced axial CT scan reveals heterogenous 2 cm low-attenuated lesion (arrow) around head of pancreas (portal phase). (B) Cut surface of tumor shows relatively well-defined and grayish-white round mass. (C) Tumor demonstrates trabecular growth pattern of acinic tumor cells (H&E stain, ×200). (D) Contrast-enhanced coronal CT scans show two metastatic tumors within segment II of liver on 58 months after surgery (portal phase).

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  Fig. 2 (A) Magnetic resonance cholangiopancreatography shows focal stenosis (arrow) of pancreatic duct in head and diffuse duct dilatation of body and tail. (B) Endoscopic retrograde cholangiopancreatography findings shows filling defect (arrow) of pancreatic duct between head and body, as well as diffuse dilatation of body and tail of pancreatic duct. (C) Pancreatic head reveals an ill-defined whitish multi-nodular solid mass, measuring 1.2 cm in diameter. (D) Microscopic view demonstrates mostly solid and focally tubular tumor nests. Tumor cells have relatively uniform oval nuclei and moderate amount eosinophilic granular cytoplasm (H&E stain, ×400).

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