Pancreatic acinar cell carcinoma with a ductal adenocarcinoma component: a case report and analysis of the histogenesis of the tumor

Autor: Tamotsu Togawa, Takanori Goi, Atsushi Iida, Yasunori Sato, Hidetoshi Onchi, Toshihisa Kimura, Shinsuke Tabata
Rok vydání: 2020
Předmět:
Male
Pathology
medicine.medical_specialty
Acinar–ductal metaplasia
lcsh:Surgery
Case Report
Breast Neoplasms
medicine.disease_cause
lcsh:RC254-282
Metastasis
03 medical and health sciences
0302 clinical medicine
Pancreatic cancer
medicine
Humans
Mixed acinar carcinoma
Acinar cell carcinoma
Aged
Pancreatic duct
Magnetic resonance cholangiopancreatography
Ductal adenocarcinoma
medicine.diagnostic_test
Carcinoma
Acinar Cell
business.industry
Bile duct
lcsh:RD1-811
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
Pancreatic Neoplasms
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Tumorigenesis
030211 gastroenterology & hepatology
Surgery
KRAS
Neoplasm Recurrence
Local
Pancreas
business
Carcinoma
Pancreatic Ductal
Pancreatic Acinar Cell Carcinoma
Zdroj: World Journal of Surgical Oncology, Vol 18, Iss 1, Pp 1-7 (2020)
World Journal of Surgical Oncology
ISSN: 1477-7819
Popis: Background Pancreatic cancer composed of acinar cell carcinoma (ACC) and ductal adenocarcinoma (DAC) is rare, and the clinicopathological characteristics of ACC with DAC have yet to be elucidated. Herein, we report a case of ACC with a DAC component of the pancreas and examined the histogenesis of this tumor. Case presentation A 69-year-old man was admitted to our hospital complaining of appetite loss, constipation, epigastric dull pain, and jaundice. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed a pancreatic head tumor with dilatation of the bile duct and the distal main pancreatic duct. Under the diagnosis of pancreatic head cancer, a pancreatoduodenectomy was performed. The histology of the resected tumor consisted of mainly ACC with a focus of DAC, which was confirmed by mucin staining and immunohistochemistry for antigens such as BCL10, trypsin, Smad4, p16, p53, and MUC1. There was histological transition between the components of ACC and DAC, and immunostaining of the transitional zone showed equivocal results for the antigens. KRAS was wild-type in both ACC and DAC. The patient was treated with adjuvant chemotherapy with S-1 for 1 year. No evidence of recurrence or metastasis was observed after 9 years of follow-up. Conclusions A rare case of pancreatic ACC with a DAC component in a patient with long-term survival after surgery was reported. Immunohistochemical and molecular analysis indicated that DAC might have arisen from ACC through transdifferentiation in this case.
Databáze: OpenAIRE
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