Acinar cell carcinoma of the pancreas

Last revised by Dr Daniel J Bell on 06 Jul 2021

Pancreatic acinar cell carcinoma is a rare exocrine neoplasm that comprises ~1% of all pancreatic tumors. This tumor shows more aggressive behavior than the far more common adenocarcinoma 1,3,4.

High levels of serum lipase, due to hypersecretion syndrome, resulting in subcutaneous fat necrosis form part of its presentation 2,3,5.

  • on contrast-enhanced CT, pancreatic acinar cell carcinomas, generally presents as an enhancing, oval and solid pancreatic tumor
  • hypo/hyperattenuating mass relative to the pancreas, with well-distinguished margins
  • non-biliary duct dilation. Only 17% of the patients present with bile duct dilatation this is one of the differentiating features with adenocarcinoma 1
  • hypovascular tumor with adjacent organ invasion
  • internal calcification is seen in 50% of cases
  • tumor encapsulation 
  • peripancreatic lymph nodes

In cases of disease confinement to the pancreas, surgical resection is curative and in cases of distant metastasis, surgery followed by chemotherapy and radiotherapy is the treatment of choice 1,2,4.

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Cases and figures

  • Case 1: on CT
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  • Case 1: on MRI
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