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Ong MJ, Tang YL, Tan CH
Correspondence: Dr Ong Jian Fu Marcus, marcus.ong@mohh.com.sg
ABSTRACT
A 50-year-old Chinese man presented to the clinic with left hypochondrial pain, more than 10 kg of weight loss over a 3-month period, and a firm, large, ill-defined mass in the left upper quadrant. Contrastenhanced computed tomography of the abdomen and pelvis revealed a well-circumscribed exophytic pancreatic mass with features suggestive of acinar cell carcinoma (ACC). The patient underwent chemotherapy and radiotherapy, with no evidence of local recurrence detected at one-year follow-up. He remains under close surveillance by his oncologist. Treatment for ACC includes surgical resection with adjuvant radiotherapy. Better overall survival is seen in patients with surgically resectable ACC as compared to those with the more common ductal cell carcinoma.
Keywords: acinar cell carcinoma, cancer, computed tomography, pancreas
Singapore Med J 2014; 55(11): 564-568; http://dx.doi.org/10.11622/smedj.2014151
REFERENCES
| 1. Kitagami H, Kondo S, Hirano S, et al. Acinar cell carcinoma of the pancreas: clinical analysis of 115 patients from Pancreatic Cancer Registry of Japan Pancreas Society. Pancreas 2007; 35:42-6. http://dx.doi.org/10.1097/mpa.0b013e31804bfbd3 | ||||
| 2. Key C. Cancer of the pancreas. In: Bethesda MD. National Cancer Institute. SEER Survival Monograph: Cancer Survival Among Adults: US SEER Program, 1988-2001, Patient and Tumor Characteristics. Publication no.: NIH-07-6215. | ||||
| 3. Matos JM, Schmidt CM, Turrini O, et al. Pancreatic acinar cell carcinoma: a multi-institutional study. J Gastrointest Surg 2009; 13:1495-502. http://dx.doi.org/10.1007/s11605-009-0938-z | ||||
| 4. Tatli S, Mortele KJ, Levy AD, et al. CT and MRI features of pure acinar cell carcinoma of the pancreas in adults. AJR Am J Roentgenol 2005; 184:511?9. http://dx.doi.org/10.2214/ajr.184.2.01840511 | ||||
| 5. Chiou YY, Chiang JH, Hwang JI, et al. Acinar cell carcinoma of the pancreas: clinical and computed tomography manifestations. J Comput Assist Tomogr 2004; 28:180-6. http://dx.doi.org/10.1097/00004728-200403000-00005 | ||||
| 6. Raman SP, Hruban RH, Cameron JL, et al. Acinar cell carcinoma of the pancreas: computed tomography features--a study of 15 patients. Abdom Imaging 2013; 38:137-43. http://dx.doi.org/10.1007/s00261-012-9868-4 | ||||
| 7. Bhosale P, Balachandran A, Wang H, et al. CT imaging features of acinar cell carcinoma and its hepatic metastases. Abdom Imaging 2012; 38:1383?90. http://dx.doi.org/10.1007/s00261-012-9970-7 | ||||
| 8. Ahn SS, Kim MJ, Choi JY, et al. Indicative findings of pancreatic cancer in prediagnostic CT. Eur Radiol 2009; 19:2448-55. http://dx.doi.org/10.1007/s00330-009-1422-6 | ||||
| 9. Buetow PC, Buck JL, Pantongrag-Brown L, et al. Solid and papillary epithelial neoplasm of the pancreas: imaging-pathologic correlation on 56 cases. Radiology 1996; 199:707-11. http://dx.doi.org/10.1148/radiology.199.3.8637992 | ||||
| 10. Fishman EK, Kuhlman JE, Jones RJ. CT of lymphoma: spectrum of disease. Radiographics 1991; 11:647-69. http://dx.doi.org/10.1148/radiographics.11.4.1887120 | ||||
| 11. Lee WK, Lau EW, Duddalwar VA, Stanley AJ, Ho YY. Abdominal manifestations of extranodal lymphoma: spectrum of imaging findings. AJR Am J Roentgenol 2008; 191:198-206. http://dx.doi.org/10.2214/AJR.07.3146 | ||||
| 12. Seth AK, Argani P, Campbell KA, et al. Acinar cell carcinoma of the pancreas: an institutional series of resected patients and review of the current literature. J Gastrointest Surg 2008; 12:1061-7. http://dx.doi.org/10.1007/s11605-007-0338-1 | ||||
| 13. Klimstra DS, Heffess CS, Oertel JE, Rosai J. Acinar cell carcinoma of the pancreas. A clinicopathologic study of 28 cases. Am J Surg Pathol 1992; 16:815-37. http://dx.doi.org/10.1097/00000478-199209000-00001 | ||||
| 14. Klimstra DS. Nonductal neoplasms of the pancreas. Mod Pathol 2007; 20 suppl 1:S94-112. http://dx.doi.org/10.1038/modpathol.3800686 | ||||
| 15. Klimstra DS, Hurban RH, Kloppel G. Acinar cell neoplasm of the pancreas. In: Bosman FT, Carnerio F, Hruban RH, Theise ND, eds. WHO Classification of Tumours of the Digestive System. Lyon: IARC, 2010: 314?8. | ||||
| 16. La Rosa S, Adsay V, Albarello L, et al. Clinicopathologic study of 62 acinar cell carcinomas of the pancreas: insights into the morphology and immunophenotype and search for prognostic markers. Am J Surg Pathol 2012; 36:1782-95. http://dx.doi.org/10.1097/PAS.0b013e318263209d | ||||
| 17. Holen KD, Klimstra DS, Hummer A, et al. Clinical characteristics and outcomes from an institutional series of acinar cell carcinoma of the pancreas and related tumors. J Clin Oncol 2002; 20:4673-8. http://dx.doi.org/10.1200/JCO.2002.02.005 | ||||