Acinar cell carcinoma of the pancreas: An institutional series of resected patients and review of the current literature

被引:81
作者
Seth, Akhil K. [1 ]
Argani, Pedram [2 ,3 ]
Campbell, Kurtis A. [1 ]
Cameron, John L. [1 ]
Pawlik, Timothy M. [1 ]
Schulick, Richard D. [1 ]
Choti, Michael A. [1 ]
Wolfgang, Christopher L. [1 ]
机构
[1] Johns Hopkins Med Inst, Dept Surg, Baltimore, MD 21287 USA
[2] Johns Hopkins Med Inst, Dept Pathol, Baltimore, MD 21287 USA
[3] Johns Hopkins Med Inst, Dept Oncol, Baltimore, MD 21287 USA
关键词
acinar cell; resection; carcinoma; pancreas;
D O I
10.1007/s11605-007-0338-1
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Introduction Acinar cell carcinoma (ACC) is a rare, malignant neoplasm with a generally poor prognosis. We report our institutional series of 14 patients with ACC to determine current guidelines for their evaluation and treatment. Materials and Methods The Johns Hopkins pathology prospective database was reviewed from 1988 to 2006 to identify patients with pancreatic neoplasms possessing features of acinar cell differentiation. Retrospective review and follow-up was performed for each patient. Results Fourteen patients with ACC were identified with a median age of 57 years. All patients presented with abdominal pain or discomfort with none showing evidence of lipase hypersecretion syndrome. Each patient underwent surgical resection, including nine pancreaticoduodenectomies and five distal pancreatectomies. Median tumor size was 3.9 cm with 12 patients found to have stage IIB disease or worse. Four patients underwent neoadjuvant chemoradiation. Eight of the fourteen patients developed recurrent disease. Overall median survival and disease-free survival were 33 and 25 months, respectively, as compared to a median survival of 18 months for pancreatic adenocarcinoma. Conclusion Acinar cell carcinomas are rare, aggressive neoplasms that are difficult to diagnose and treat. Operative resection represents the best first-line treatment. These lesions have a better prognosis than the more common pancreatic adenocarcinomas.
引用
收藏
页码:1061 / 1067
页数:7
相关论文
共 45 条
[1]  
ALCANTARA EN, 1962, CAN MED ASSOC J, V87, P970
[2]  
[Anonymous], ANN SURG
[3]   Subcutaneous fatty tissue necrosis. [J].
Berner, O .
VIRCHOWS ARCHIV FUR PATHOLOGISCHE ANATOMIE UND PHYSIOLOGIE UND FUR KLINISCHE MEDIZIN, 1908, 193 (04) :510-518
[4]  
BURNS WA, 1974, CANCER, V33, P1002, DOI 10.1002/1097-0142(197404)33:4<1002::AID-CNCR2820330415>3.0.CO
[5]  
2-R
[6]  
CARUSO RA, 1994, HISTOL HISTOPATHOL, V9, P53
[7]   Concurrent chemoradiation is effective in the treatment of alpha-fetoprotein-producing acinar cell carcinoma of the pancreas: Report of a case [J].
Chen, CP ;
Chao, Y ;
Li, CP ;
Lee, RC ;
Tsay, SH ;
Chi, KH ;
Yen, SH ;
Chang, FY ;
Lee, SD .
PANCREAS, 2001, 22 (03) :326-329
[8]   MORPHOLOGICAL-STUDY OF 391 CASES OF EXOCRINE PANCREATIC TUMORS WITH SPECIAL REFERENCE TO THE CLASSIFICATION OF EXOCRINE PANCREATIC-CARCINOMA [J].
CHEN, J ;
BAITHUN, SI .
JOURNAL OF PATHOLOGY, 1985, 146 (01) :17-29
[9]   Acinar cell carcinoma of the pancreas - Clinical and computed tomography manifestations [J].
Chiou, YY ;
Chiang, JH ;
Hwang, JI ;
Yen, CH ;
Tsay, SH ;
Chang, CY .
JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 2004, 28 (02) :180-186
[10]   Alpha-fetoprotein production by pancreatic tumors exhibiting acinar cell differentiation: Study of five cases, one arising in a mediastinal teratoma [J].
Cingolani, N ;
Shaco-Levy, R ;
Farruggio, A ;
Klimstra, DS ;
Rosai, J .
HUMAN PATHOLOGY, 2000, 31 (08) :938-944