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A case of mixed acinar-endocrine carcinoma of the pancreas discovered in an asymptomatic subject

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Summary

A 50-yr-old Japanese man was found to have a hypoechoic mass 3 cm in diameter in the pancreatic head on an ultrasonography (US) examination without symptoms. A computed tomography (CT) scan demonstrated a 3-cm solid mass in the pancreatic head, and it was more clearly delineated as a low-density area on enhanced CT. Angiography showed a tumorlike stain, 3 cm in size, in the pancreatic head. The preoperative diagnosis was “special type of pancreatic tumor such as acinar cell carcinoma or non-functioning islet cell tumor.” The patient was treated by pylorus-preserving pancreatoduodenectomy. Histological, immunohistochemical, and electron-microscopic studies of the surgical specimen led to a definitive diagnosis of a mixed acinar-endocrine carcinoma. The patient is currently well, with no signs of tumor recurrence, 18 mo after the operation. Our search of the Japanese and English-language literature retrieved only 15 welldocumented cases of mixed acinar-endocrine carcinoma. Imaging in the reported cases revealed features of either acinar cell carcinoma or islet cell tumor, or both, which can may be detected even in small tumors more easily than conventional invasive ductal carcinoma of the pancreas because the detectability of this rare tumor on US and CT seems to be good.

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References

  1. Solcia E, Capella C, Kloppel G. General considerations, in Tumors of the Pancreas, Atlas of Tumor Pathology, third series, fascicle 20: Armed Forces Institute of Pathology, Rosai J, Sobin LH, eds. Washington, DC, 1997, pp. 29, 30.

    Google Scholar 

  2. Lack EE. Primary tumors of the exocrine pancreas. Classification, overview, and recent contributions by immunohistochemistry and electron microscopy. Am J Surg Pathol 1989; 13 (Suppl. 1): 66–88.

    PubMed  Google Scholar 

  3. Ulich T, Cheng L, Lewin KJ. Acinar-endocrine cell tumor of the panceras. Report of a pancreatic tumor containing both zymogen and neuroendocrine granules. Cancer 1982; 50: 2099–2105.

    Article  PubMed  CAS  Google Scholar 

  4. Ichijima K, Akaishi K, Toyoda N, Kobayashi Y, Ueda Y, Matsuo S, et al. Carcinoma of the pancreas with endocrine component in childhood. A case report. Am J Clin Pathol 1985; 83: 95–100.

    PubMed  CAS  Google Scholar 

  5. Machida H, Nakaya Y, Kojima K, Kanzaki M, Toda E, Tobayama S. A case of acinar-islet cell tumor of the pancreas body (in Japanese with English abstract). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 1991; 92: 603–606.

    CAS  Google Scholar 

  6. Moriyama S, Kawashima K, Hanaoka T, Ohashi R, Uko T, Hayashi T, et al. A case of asymptomatic islet-acinar cell carcinoma of the pancreas. A histochemical and immunohistochemical study of cell differentiation of the tumor (in Japanese). Tan to Sui 1992; 13: 437–442.

    Google Scholar 

  7. Klimstra DS, Rosai J, Heffess CS. Mixed acinar-endocrine carcinomas of the pancreas. Am J Surg Pathol 1994; 18: 765–778.

    Article  PubMed  CAS  Google Scholar 

  8. Cho KJ, Kim JY, Lee SS, Khang SK, Kim CW. Mixed acinar-endocrine carcinoma of the pancreas. A case report. J Korean Med Sci 1996; 2: 188–192.

    Google Scholar 

  9. Ueda J, Konishi I, Hirono S, Kurozaki M, Ueda T, Sugihara M, et al. A case of acinar-endocrine cell carcinoma of the pancreas (in Japanese). Tan to Sui 1997; 18(Suppl.): 899–903.

    Google Scholar 

  10. Shimoike T, Goto M, Nakano I, Sato T, Migita Y, Ito T, et al. Acinar-islet cell carcinoma presenting as insulinoma. J Gastroenterol 1997; 32: 830–835.

    Article  PubMed  CAS  Google Scholar 

  11. Igarashi N, Katsumata T, Nakayama T, Kikuchi K. A case of acinar-islet cell carcinoma—with reference to the imaging diagnosis—(abstract in English). J Jpn Soc Clin Surg 1997; 58: 1630–1634.

    Google Scholar 

  12. Frank M, Bittinger A, Rothmund M, Arnold R. Immunohistochemical analysis and clinical course of high-malignant composite endocrine-acinar cell carcinoma: A case report. Pancreas 1998; 17: 210–212.

    Article  PubMed  CAS  Google Scholar 

  13. Hsu SM, Raine L, Fanger H. The use of avidin-biotinperoxidase complex (ABC) in immunoperoxidase technique: a comparison between ABC and unlabeled antibody (PAP) procedures. J Histochem Cytochem 1981; 29: 577–580.

    PubMed  CAS  Google Scholar 

  14. Tucker JA, Shelburne JD, Benning TL, Yacoub L, Federman M. Filamentous inclusions in acinar cell carcinoma of pancreas. Ultrastruct Pathol 1994; 18: 279–286.

    Article  PubMed  CAS  Google Scholar 

  15. Hoorens A, Lemoine NR, McLellan E, Morohoshi T, Kamisawa T, Heitz PU, et al. Pancreatic acinar cell carcinoma. An analysis of cell lineage markers, p53 expression and Ki-ras mutations. Am J Pathol 1993; 143: 685–698.

    PubMed  CAS  Google Scholar 

  16. 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: 815–837.

    Article  PubMed  CAS  Google Scholar 

  17. Furukawa H, Mukai K, Kosuge T, Kanai Y, Shimada K, Yamamoto J, et al. Nonfunctioning islet cell tumors of the pancreas: Clinical, imaging and pathological aspects in 16 patients. Jpn J Clin Oncol 1998; 28: 255–261.

    Article  PubMed  CAS  Google Scholar 

  18. Fugazzola C, Procacci C, Andreis IAB, Iacono C, Portuese A, Mansueto G, et al. The combination of ultrasonography and computed tomography in the diagnosis of nonfunctioning islet cell tumors of the pancreas. Gastrointest Radiol 1990; 15: 139–144.

    Article  PubMed  CAS  Google Scholar 

  19. Lim JH, Chung KB, Cho OK, Cho KS. Acinar cell carcinoma of the pancreas ultrasonography and computed tomography findings. Clin Imaging 1990; 14: 301–304.

    Article  PubMed  CAS  Google Scholar 

  20. Mergo PJ, Helmberger TK, Buetow PC, Helmberger RC, Ros PR. Pancreatic neoplasms: MR imaging and pathologic correlation. RadioGraphics 1997; 17: 281–301.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, Yamada Red Cross Hospital, Japan

    Tadashi Yabana

  2. First Department of Surgery, Mie University School of Medicine, Mie, Japan

    Shuji Isaji

  3. Department of Surgery, Yamada Red Cross Hospital, 810, Takabuku, Misono-mura, Watarai-gun, 516-0805, Mie, Japan

    Tomoko Ogawa

Authors
  1. Tomoko Ogawa
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  2. Shuji Isaji
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  3. Tadashi Yabana
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Correspondence to Tomoko Ogawa.

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Ogawa, T., Isaji, S. & Yabana, T. A case of mixed acinar-endocrine carcinoma of the pancreas discovered in an asymptomatic subject. International Journal of Pancreatology 27, 249–257 (2000). https://doi.org/10.1385/IJGC:27:3:249

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  • DOI: https://doi.org/10.1385/IJGC:27:3:249

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