A Case of Acinar Cell Carcinoma of the Pancreas with Invasion into the Superior Mesenteric Vein

Hisamitsu Shinohara, Takashi Koyama, Shigeru Kurisu, Masahiko Umeki, Takashi Kitade, Hideyuki Takahashi and Shingo Wakatsuki*

Department of Surgery and Department ofPathology*, Hyogo Prefectural Awaji Hospital

We report a case of acinar cell carcinoma of the pancreas with invasion into the superior mesenteric vein (SMV). A 42-year-old man was referred for an abdominal giant tumor, found during an examination for hematuria. On admission, the tumor was palpable at the right epigastrium, but anemia and jaundice were not recognized. Laboratory data showed slight liver function disturbance, but CEA and CA19-9. Abdominal CT showed a giant 9× 6× 10 cm tumor in the right upper abdomen. Celiac arteriography showed tumor hypervascularity, and portography SMV defect pressing on the tumor. Based on these findings, a diagnosis of malignant tumor at the pancreas head was made, necessitating pancreato-duodenectomy for the pancreatic tumor and partial SMV resection. During surgery, no findings suggested metastasis to any organ. Pathohistologically, the tumor was diagnosed as acinar cell carcinoma of the pancreas with invasion to the SMV. No lymph nods metastasis was identified histologically. Although the postoperative course was uneventful, it is necessary to carefully follow up such cases for possible recurrence and liver metastasis of carcinoma.

Key words
pancreas, acinar cell carcinoma, invasion into superior mesenteric vein

Reprint requests
Hisamitsu Shinohara Department of Surgery, University of Tokushima School of Medicine
3-18-5 Kuramoto-cho, Tokushima-city, 770-8501 JAPAN

Accepted
July 28, 2004

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