Clinical Study of Acinar Cell Carcinomas of the Pancreas: Our 5 cases and a review of 5 cases reported in Korea

Kim, Min Chan; Kim, Hyung Ho; Jung, Ghap Joong; Kim, Sang Soon

Abstract

PURPOSE: A acinar cell carcinoma of the pancreas is a rare malignancy arising from exocrine cells and comprising about 0.2 to 1% of all pancreatic cancers. Acinar cell carcinomas are usually seen in elderly patients and show a poor prognosis due to frequent metastasis. So far, we have not found any report of a clinical analysis of acinar cell carcinomas in Korean.
METHODS
The records of 5 patients of Dong-A University Hospital and 5 patients already reported on in other literature in Korea were reviewed. The clinical and radiohistologic characteristics, treatment and prognosis were analyzed.
RESULTS
The patients consisted of 8 males and 2 female. The patients ranged in age from 25 to 68 years (mean, 49.3 years). Presenting symptoms were nonspecific, and jaundice was infrequent. The symptoms from increased serum lipase levels were present in 2 (20.0%) of the patients. The tumor was frequently located on the tail (6 cases, 60.0%) of the pancreas. The histologic finding showed an acinar arrangement of the tumor cells with a minute central lumen. Ultrastructurely, the tumor cells had a few zymogen granules. The mean size of the tumors was 7.5 cm. We found that 1 case among the 10 cases had an elevated CA19-9 level among 10 cases and no one had an elevated AFP or CEA level among our 5 cases. A radical resection was performed in 7 cases, and the mean survival was 44.0 months. The mean survival of the 10 cases was 35.4 months.
CONCLUSION
An acinar cell carcinoma is a rare type of pan creatic cancer and has a more favorable prognosis than a pancreatic ductal carcinoma. The clinical outcome and the radiohistologic characteristics were similar to those in other foreign literature, but the age, the tumor locations and the tumor marker (AFP or CEA) of the patients in this study were different from those of Caucasians.