Pancreatic acinar cell carcinoma a rare exocrine pancreatic neoplasm that exemplifies ~1% of all pancreatic tumors. This tumor shows more aggressive behavior than its counterpart adenocarcinoma 1,3,4.
High levels of serum lipase noted in serum, due to hypersecretion syndrome, resulting in subcutaneous fat necrosis 2,3,5.
- On contrast-enhanced CT imaging, 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
Treatment and prognosis
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 choice1,2,4.
- 1. Barat M, Barat DA, Barat GS, Barat HC, Barat JD, Barat OA, Barat CR, Barat BM, Barat TB, Barat SP, Barat. Computed tomography features of acinar cell carcinoma of the pancreas. (2020) Diagnostic and interventional imaging. doi:10.1016/j.diii.2020.02.007 - Pubmed
- 2. Mustafa S, Hruban RH, Ali SZ. Acinar cell carcinoma of the pancreas: a clinicopathologic and cytomorphologic review. J Am Soc Cytopathol. 2020 Nov-Dec;9(6):586-595. doi: 10.1016/j.jasc.2020.04.005. Epub 2020 Apr 25. PMID: 32461075.
- 3. Miksch R, Miksch ST, Miksch WM, Miksch IM, Miksch KP, Miksch GM, Miksch AM, Miksch WJ, Miksch D3, Miksch HJ, Miksch. Pancreatic panniculitis and elevated serum lipase in metastasized acinar cell carcinoma of the pancreas: A case report and review of literature. (2020) World journal of clinical cases. doi:10.12998/wjcc.v8.i21.5304 - Pubmed
- 4. Duorui N, Shi B, Zhang T, Chen C, Fang C, Yue Z, Wu P, Wu Z, Huang X, Li M. The contemporary trend in worsening prognosis of pancreatic acinar cell carcinoma: A population-based study. (2020) PloS one. 15 (12): e0243164. doi:10.1371/journal.pone.0243164 - Pubmed
- 5. Zong Y, Zong QC, Zong PZ, Zong SL, Zong ZJ, Zong. Patients With Acinar Cell Carcinoma of the Pancreas After 2005: A Large Population Study. (2020) Pancreas. doi:10.1097/MPA.0000000000001573 - Pubmed