A case of pancreatic acinar cell carcinoma metastatic to skin

Abstract

We report a rare case of pancreatic acinar cell carcinoma with widespread metastases in a 68-year-old woman who presented with subcutaneous nodules as the initial symptom. Computed tomography showed a pancreatic mass with hepatic tumors and enlarged lymph nodes besides ring-enhanced subcutaneous nodules. Magnetic resonance diffusionweighted imaging detected the presence of lesions in other organs. Histological analysis of a colonic polypoid lesion revealed carcinoma with endocrine and acinar differentiation compatible with pancreatic origin. Regrettably, she died of a cerebral infarction without any treatment, and autopsy findings confirmed our diagnosis.

Skin Metastases: The Visible Face of a Disastrous Unusual Finding

“…Acinar cell carcinoma (ACC) of the pancreas is a rare pancreatic malignancy, constituting only 1–2% of all exocrine pancreatic tumors. 1 , 2 , 3 There is a slight male preponderance and it mostly presents in 5–7th decades of life. ACC arise more commonly from the head of the pancreas.…”

“…Skin nodules in this syndrome are commonly seen on the lower extremities and often mistaken for metastatic disease. 1 , 2 , 3 Surgical resection is the best treatment for localized ACC but this is a highly aggressive tumor. Approximately 50% of the cases presented with metastasis at diagnosis.…”

“…More than 70% the patients who undergo surgical resection are eventually confirmed to show recurrent disease. 2 , 3 Chemotherapy and radiotherapy are therapeutic options when ACC is unresectable or recurs after resection, but no effective treatment strategies have been established. Although recent studies have clarified the characteristics of ACC it still has not been fully understood.…”