A Case of Acinar Cell Carcinoma of the Pancreas with Intraductal Tumor Growth to the Main Pancreatic Duct

Shunsuke Onoe, Takehito Katoh, Yoshihisa Shibata, Masaomi Suzuki, Kazuhiro Hiramatsu, Motoi Yoshihara, Takasi Ikeyama, Kiyosi Suzumura, Tetsusi Mizutani and Harumitsu Ando

Department of Surgery, Toyohashi Municipal Hospital

We report a case of acinar cell carcinoma (ACC) of the pancreas head with intraductal tumor growth to the main pancreatic duct. A 46-year-old woman was admitted because of a pancreatic tumor found during a general hospital examination. On admission, the patient showed no signs of abdominal pain or jaundice. Laboratory data showed mild elevations of serum pancreatic amylase and CA19-9. An abdominal ultrasonography and CT examination showed a solid tumor, 5 cm in diameter, with a distinct border and expansive growth in the head of the pancreas as well as dilation of the distal pancreatic duct. Pancreatography showed an elliptic-filling defect in the main pancreatic duct. A pylorus-preserving pancreatoduodenectomy was performed. Macroscopically, the tumor was encapsulated and had a well-circumscribed appearance without invasion to the surrounding organs. Microscopically, it was diagnosed as an acinar cell carcinoma with intraductal tumor growth to the main pancreatic duct. The patient has been well for 8 months. Among domestically reported cases of ACC over the past 10 years, 40 resections were reported; three of these cases presented with intraductal tumor growth. ACC occasionally undergoes intraductal tumor growth, probably as a result of its expansive growth characteristic.

Key words
acinar cell carcinoma, intraductal tumor growth

Reprint requests
Shunsuke Onoe Toyohashi Municipal Hospital
50 Hakkennishi, Aotake-cho, Toyohashi, 441-8570 JAPAN

Accepted
June 28, 2006

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