Advertisement

The Unusual Suspects of the Pancreas—Understanding Pancreatic Acinar Cell Carcinomas and Adenomas

  • Andreas Minh Luu
  • Tim FahlbuschEmail author
  • Johanna Munding
  • Waldemar Uhl
  • Chris Braumann
Original Research
  • 26 Downloads

Abstract

Purpose

Acinar cell carcinomas (ACC) and adenomas (ACA) of the pancreas are rare entities. Sufficient knowledge about occurrence and prognosis is scarce.

Methods

A retrospective chart review of our database was performed for all patients who had undergone pancreatic surgery between 2006 and 2018. Results were compared to recent literature findings.

Results

Nine patients were diagnosed with ACC and four patients with ACA of the pancreas in the study period. ACC patients were older and more often male than patients of the ACA group. ACC were mainly localized in the pancreatic head, whereas ACA were more often found in the distal pancreas. Tumor markers are not necessarily elevated, even in case of malignancy.

Conclusions

ACC and ACA are very rare pancreatic tumors. Both entities account for less than 1% of all pancreatic neoplasms. Diagnosis is challenging due to unspecific radiologic features and clinical symptoms. Nevertheless, a patient complaining of abdominal discomfort and an unclear hypodense pancreatic lesion should undergo surgical exploration.

Keywords

Acinar cell adenoma Acinar cell carcinoma Pancreatic tumor Pancreatic surgery Pancreatic carcinoma 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Wang G, Ji L, Qu F-Z, Le Li CC-L, Li Z-B, et al. Acinar cell cystadenoma of the pancreas: a retrospective analysis of ten-year experience from a single academic institution. Pancreatology. 2016;16(4):625–31.CrossRefGoogle Scholar
  2. 2.
    Singhi AD, Norwood S, Liu T-C, Sharma R, Wolfgang CL, Schulick RD, et al. Acinar cell cystadenoma of the pancreas: a benign neoplasm or non-neoplastic ballooning of acinar and ductal epithelium? Am J Surg Pathol. 2013;37(9):1329–35.CrossRefGoogle Scholar
  3. 3.
    Berner O. Subkutane Fettgewebsnekrose. Virchows Arch path Anat. 1908;193(3):510–8.CrossRefGoogle Scholar
  4. 4.
    Zamboni G, Terris B, Scarpa A, Kosmahl M, Capelli P, Klimstra DS, et al. Acinar cell cystadenoma of the pancreas: a new entity? Am J Surg Pathol. 2002;26(6):698–704.CrossRefGoogle Scholar
  5. 5.
    Seth AK, Argani P, Campbell KA, Cameron JL, Pawlik TM, Schulick RD, et al. Acinar cell carcinoma of the pancreas: an institutional series of resected patients and review of the current literature. J Gastrointest Surg. 2008;12(6):1061–7.CrossRefGoogle Scholar
  6. 6.
    Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery. 2017;161(3):584–91.CrossRefGoogle Scholar
  7. 7.
    Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187–96.CrossRefGoogle Scholar
  8. 8.
    Tanaka M, Fernández-Del Castillo C, Kamisawa T, Jang JY, Levy P, Ohtsuka T, et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 2017;17(5):738–53.CrossRefGoogle Scholar
  9. 9.
    Klimstra DS, Heffess CS, Oertel JE, Rosai J. Acinar cell carcinoma of the pancreas. A clinicopathologic study of 28 cases. Am J Surg Pathol. 1992;16(9):815–37.CrossRefGoogle Scholar
  10. 10.
    Chaudhary P. Acinar cell carcinoma of the pancreas: a literature review and update. Indian J Surg. 2015;77(3):226–31.CrossRefGoogle Scholar
  11. 11.
    Bachmann J, Büchler MW, Friess H, Martignoni ME. Cachexia in patients with chronic pancreatitis and pancreatic cancer: impact on survival and outcome. Nutr Cancer. 2013;65(6):827–33.CrossRefGoogle Scholar
  12. 12.
    Holen KD, Klimstra DS, Hummer A, Gonen M, Conlon K, Brennan M, et al. Clinical characteristics and outcomes from an institutional series of acinar cell carcinoma of the pancreas and related tumors. J Clin Oncol. 2002;20(24):4673–8.CrossRefGoogle Scholar
  13. 13.
    Kuopio T, Ekfors TO, Nikkanen V, Nevalainen TJ. Acinar cell carcinoma of the pancreas. Report of three cases. APMIS. 1995;103(1):69–78.CrossRefGoogle Scholar
  14. 14.
    Delavaud C, d'Assignies G, Cros J, Ruszniewski P, Hammel P, Levy P, et al. CT and MR imaging of multilocular acinar cell cystadenoma: comparison with branch duct intraductal papillary mucinous neoplasia (IPMNs). Eur Radiol. 2014;24(9):2128–36.CrossRefGoogle Scholar
  15. 15.
    Toll AD, Hruban RH, Ali SZ. Acinar cell carcinoma of the pancreas: clinical and cytomorphologic characteristics. Korean J Pathol. 2013;47(2):93–9.CrossRefGoogle Scholar
  16. 16.
    Yoo C, Kim BJ, Kim K-P, Lee J-L, Kim TW, Ryoo B-Y, et al. Efficacy of chemotherapy in patients with unresectable or metastatic pancreatic acinar cell carcinoma: potentially improved efficacy with oxaliplatin-containing regimen. Cancer Res Treat. 2017;49(3):759–65.CrossRefGoogle Scholar
  17. 17.
    Schmidt CM, Matos JM, Bentrem DJ, Talamonti MS, Lillemoe KD, Bilimoria KY. Acinar cell carcinoma of the pancreas in the United States: prognostic factors and comparison to ductal adenocarcinoma. J Gastrointest Surg. 2008;12(12):2078–86.CrossRefGoogle Scholar
  18. 18.
    Sakorafas GH, Smyrniotis V, Reid-Lombardo KM, Sarr MG. Primary pancreatic cystic neoplasms of the pancreas revisited. Part IV: rare cystic neoplasms. Surg Oncol. 2012;21(3):153–63.CrossRefGoogle Scholar
  19. 19.
    Leeds JS, Nayar MN, Dawwas M, Scott J, Anderson K, Haugk B, et al. Comparison of endoscopic ultrasound and computed tomography in the assessment of pancreatic cyst size using pathology as the gold standard. Pancreatology. 2013;13(3):263–6.CrossRefGoogle Scholar
  20. 20.
    Matos JM, Schmidt CM, Turrini O, Agaram NP, Niedergethmann M, Saeger HD, et al. Pancreatic acinar cell carcinoma: a multi-institutional study. J Gastrointest Surg. 2009;13(8):1495–502.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Andreas Minh Luu
    • 1
  • Tim Fahlbusch
    • 1
    Email author
  • Johanna Munding
    • 2
  • Waldemar Uhl
    • 1
  • Chris Braumann
    • 1
  1. 1.Department of General and Visceral Surgery, St. Josef-Hospital, University HospitalRuhr-University BochumBochumGermany
  2. 2.Department of Pathology, Berufsgenossenschaftliches Universitätsklinikum BergmannsheilRuhr-University BochumBochumGermany

Personalised recommendations