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Pathological complete response with FOLFIRINOX therapy for recurrence of pancreatic acinar cell carcinoma

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Abstract

Pancreatic acinar cell carcinoma (PACC) is a very rare subtype of pancreatic cancer. Due to small number of patients, no standard chemotherapy protocol has been established. We experienced an extremely rare case of PACC with liver metastasis that showed a pathological complete response after modified FOLFIRINOX (mFFX) therapy. A 42-year-old man who underwent distal pancreatectomy for an 80 mm tumor at the pancreatic tail 3 years ago was referred to our hospital in September 2017 for the treatment of a recurrent liver tumor. Percutaneous biopsy revealed an acinar-neuroendocrine carcinoma, similar to the surgical specimen. He received eight cycles of irinotecan plus cisplatin chemotherapy. However, the tumor increased in size, and treatment was switched to mFFX therapy. The tumor in the liver shrank remarkably after nine cycles of mFFX therapy. Conversion surgery was selected, and the patient underwent hepatic left and caudate lobectomy 8 months after administration of mFFX. The resected specimen showed no viable tumor cells, indicating a pathological complete response. The histological diagnosis was reconsidered, and PACC was finally diagnosed via an additional immunohistological review. The patient has remained well with no recurrence for 6 years after surgery. This study is the first to report a case of pathological complete response with mFFX therapy for the recurrence of PACC.

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Acknowledgements

We would like to thank S. Tsuruta for processing surgical specimens and giving pathological findings and Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Katsuhito Teramatsu, Nao Fujimori, Masatoshi Murakami, Sho Yasumori, Kazuhide Matsumoto & Yoshihiro Ogawa

  2. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Kohei Nakata & Masafumi Nakamura

  3. Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University Hospital, Fukuoka, Japan

    Yoshinao Oda

  4. Department of Pathology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan

    Yutaka Koga

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  1. Katsuhito Teramatsu
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  2. Nao Fujimori
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  3. Masatoshi Murakami
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  4. Sho Yasumori
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Correspondence to Nao Fujimori.

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Teramatsu, K., Fujimori, N., Murakami, M. et al. Pathological complete response with FOLFIRINOX therapy for recurrence of pancreatic acinar cell carcinoma. Clin J Gastroenterol (2024). https://doi.org/10.1007/s12328-024-01983-2

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