A resected case of acinar cell carcinoma of the pancreas with liver metastasis following chemotherapy using modified FOLFIRINOX
Abstract Background Acinar cell carcinoma of the pancreas is a rare exocrine malignancy representing less than 1% of all pancreatic neoplasms. It has been reported that it responds to treatment differently from pancreatic ductal adenocarcinoma and the treatment algorithm for acinar cell carcinoma us...
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Japan Surgical Society
2023-08-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-023-01729-1 |
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| author | Shuhei Yamada Haruka Motegi Yoshiki Kurihara Tomonori Shimbo Isao Kikuchi Toshiki Wakabayashi Tsutomu Sato |
| author_facet | Shuhei Yamada Haruka Motegi Yoshiki Kurihara Tomonori Shimbo Isao Kikuchi Toshiki Wakabayashi Tsutomu Sato |
| author_sort | Shuhei Yamada |
| collection | DOAJ |
| description | Abstract Background Acinar cell carcinoma of the pancreas is a rare exocrine malignancy representing less than 1% of all pancreatic neoplasms. It has been reported that it responds to treatment differently from pancreatic ductal adenocarcinoma and the treatment algorithm for acinar cell carcinoma usually depends on the stage of the respective tumor and the patient’s current status. Case presentation A 60-year-old man presented with upper abdominal pain and anorexia. Abdominal ultrasonography showed a large-sized hepatic mass and he was referred to our hospital. Contrast-enhanced computed tomography demonstrated a 110-mm low-density area occupying the right hemi-liver and an enhanced mass of 70 × 56 mm in the tail of the pancreas, which seemed to directly infiltrate into the spleen. The case was diagnosed as acinar cell carcinoma with a simultaneous liver metastasis identified by liver biopsy. Upfront resection of pancreatic cancer with distant metastasis might not be considered as an optimal choice, and in this case chemotherapy was administered prior to curative resection. Chemotherapy using the modified FOLFIRINOX regimen was undertaken, resulting in a partial remission; the liver tumor reduced in size from 110 to 47 mm and the pancreatic tumor from 70 to 40 mm. The patient then safely underwent curative hepatic resection with distal pancreato-splenectomy. Histological examinations revealed small-sized atypical cells with large nuclei that had formed acinar patterns, and immunostaining with trypsin was positive in tumor cells, which was in accordance with acinar cell carcinoma. More than 3 years later, the patient is doing well without any recurrence. Conclusion Aggressive and curative surgery in combination with chemotherapy such as FOLFIRINOX could be a treatment option to achieve long-term survival in cases of acinar cell carcinoma with liver metastases. |
| format | Article |
| id | doaj-art-9a0ecb77268140758e907f2f7be047e4 |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-9a0ecb77268140758e907f2f7be047e42025-08-20T03:35:24ZengJapan Surgical SocietySurgical Case Reports2198-77932023-08-019111010.1186/s40792-023-01729-1A resected case of acinar cell carcinoma of the pancreas with liver metastasis following chemotherapy using modified FOLFIRINOXShuhei Yamada0Haruka Motegi1Yoshiki Kurihara2Tomonori Shimbo3Isao Kikuchi4Toshiki Wakabayashi5Tsutomu Sato6Department of Gastroenterological Surgery, Akita City HospitalDepartment of Gastroenterological Surgery, Akita City HospitalDepartment of Gastroenterological Surgery, Akita City HospitalDepartment of Gastroenterological Surgery, Akita City HospitalDepartment of Gastroenterological Surgery, Akita City HospitalDepartment of Gastroenterological Surgery, Akita City HospitalDepartment of Gastroenterological Surgery, Akita City HospitalAbstract Background Acinar cell carcinoma of the pancreas is a rare exocrine malignancy representing less than 1% of all pancreatic neoplasms. It has been reported that it responds to treatment differently from pancreatic ductal adenocarcinoma and the treatment algorithm for acinar cell carcinoma usually depends on the stage of the respective tumor and the patient’s current status. Case presentation A 60-year-old man presented with upper abdominal pain and anorexia. Abdominal ultrasonography showed a large-sized hepatic mass and he was referred to our hospital. Contrast-enhanced computed tomography demonstrated a 110-mm low-density area occupying the right hemi-liver and an enhanced mass of 70 × 56 mm in the tail of the pancreas, which seemed to directly infiltrate into the spleen. The case was diagnosed as acinar cell carcinoma with a simultaneous liver metastasis identified by liver biopsy. Upfront resection of pancreatic cancer with distant metastasis might not be considered as an optimal choice, and in this case chemotherapy was administered prior to curative resection. Chemotherapy using the modified FOLFIRINOX regimen was undertaken, resulting in a partial remission; the liver tumor reduced in size from 110 to 47 mm and the pancreatic tumor from 70 to 40 mm. The patient then safely underwent curative hepatic resection with distal pancreato-splenectomy. Histological examinations revealed small-sized atypical cells with large nuclei that had formed acinar patterns, and immunostaining with trypsin was positive in tumor cells, which was in accordance with acinar cell carcinoma. More than 3 years later, the patient is doing well without any recurrence. Conclusion Aggressive and curative surgery in combination with chemotherapy such as FOLFIRINOX could be a treatment option to achieve long-term survival in cases of acinar cell carcinoma with liver metastases.https://doi.org/10.1186/s40792-023-01729-1Acinar cell carcinomaPancreasLiver metastasesChemotherapyFOLFIRINOX |
| spellingShingle | Shuhei Yamada Haruka Motegi Yoshiki Kurihara Tomonori Shimbo Isao Kikuchi Toshiki Wakabayashi Tsutomu Sato A resected case of acinar cell carcinoma of the pancreas with liver metastasis following chemotherapy using modified FOLFIRINOX Surgical Case Reports Acinar cell carcinoma Pancreas Liver metastases Chemotherapy FOLFIRINOX |
| title | A resected case of acinar cell carcinoma of the pancreas with liver metastasis following chemotherapy using modified FOLFIRINOX |
| title_full | A resected case of acinar cell carcinoma of the pancreas with liver metastasis following chemotherapy using modified FOLFIRINOX |
| title_fullStr | A resected case of acinar cell carcinoma of the pancreas with liver metastasis following chemotherapy using modified FOLFIRINOX |
| title_full_unstemmed | A resected case of acinar cell carcinoma of the pancreas with liver metastasis following chemotherapy using modified FOLFIRINOX |
| title_short | A resected case of acinar cell carcinoma of the pancreas with liver metastasis following chemotherapy using modified FOLFIRINOX |
| title_sort | resected case of acinar cell carcinoma of the pancreas with liver metastasis following chemotherapy using modified folfirinox |
| topic | Acinar cell carcinoma Pancreas Liver metastases Chemotherapy FOLFIRINOX |
| url | https://doi.org/10.1186/s40792-023-01729-1 |
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