A Case of Acinar Cell Carcinoma of the Pancreas with Subcutaneous Fat Necrosis of Extremities

Yukiyasu Okamura, Kiyoshi Ishigure²⁾, Tadao Ishikawa, Yoshikuni Inokawa, Takashi Sugae, Tsunenobu Takase, Shigeki Nakayama, Toyohisa Yaguchi, Akio Harada and Takaaki Nakamura¹⁾

Department of Surgery and Department of Pathology¹⁾, Kainan General Hospital
Department of Surgery, Showa General Hospital²⁾

Acinar cell carcinoma of the pancreas is a rare tumor accounting for about 1% of pancreatic exocrine neoplasms. Acinar cell carcinoma with subcutaneous fat necrosis is even rarer, with only 2 such cases having been reported in Japan. A 75-year-old man admitted for appetite loss was found on physical examination to have elastic and hard mass extending 10 cm in the left upper quadrant of the abdomen. There were multiple subcutaneous nodules distributed in both legs. Laboratory tests showed a marked increase serum lipase and elastase 1. Serum CEA and CA19-9 were normal. Computed tomography scan of the abdomen showed a large mass consisting of solid and cystic lesions in the left upper quadrant. We conducted distal pancreatectomy on the diagnosis of the tumor from the pancreatic tail. The histopathological diagnosis was acinar cell carcinoma. Following surgery, serum lipase and elastase 1 decreased to normal, and skin lesions disappeared. The man remains alive without signs of recurrence 4 years after surgery.

Key words
acinar cell carcinoma of the pancreas, subcutaneous fat necrosis, lipase

Reprint requests
Yukiyasu Okamura Department of Surgery, Showa General Hospital
46 Nobaku Nobaku-cho, Konan, 483-8703 JAPAN

Accepted
October 19, 2005

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