A case of pancreatic mixed acinar–neuroendocrine carcinoma successfully diagnosed with endoscopic ultrasound-guided fine needle aspiration

Niiya, Fumitaka; Takano, Yuichi; Azami, Tetsushi; Kobayashi, Takahiro; Maruoka, Naotaka; Wakabayashi, T.; Matsuo, Keitaro; Tanaka, Kuniya; Norose, Tomoko; Ohike, Nobuyuki; Nagahama, Masatsugu

doi:10.1007/s12328-020-01136-1

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…MANEC immunohistochemically expresses both neuroendocrine and exocrine markers ( 23 , 65 , 66 ). The clinicopathological behaviour of MANEC is similar to that of PACC ( 23 , 64 , 67 ).…”

Section: Epidemiology Clinical Features Diagnosis Molecular Features ...mentioning

confidence: 68%

Comprehensive review of pancreatic acinar cell carcinoma: epidemiology, diagnosis, molecular features and treatment

Ikezawa,

Urabe,

Kai

et al. 2023

Japanese Journal of Clinical Oncology

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Pancreatic acinar cell carcinoma is a rare form (0.2–4.3%) of pancreatic neoplasm with unique clinical and molecular characteristics, which largely differ from pancreatic ductal adenocarcinoma. Pancreatic acinar cell carcinoma occurs more frequently in males and can occur in children. Serum lipase is elevated in 24–58% of patients with pancreatic acinar cell carcinoma. Pancreatic acinar cell carcinomas tend to be large at diagnosis (median tumour size: ~5 cm) and are frequently located in the pancreas head. Radiologically, pancreatic acinar cell carcinoma generally exhibits a solid appearance; however, necrosis, cystic changes and intratumoral haemorrhage can occur in larger lesions. Immunostaining is essential for the definitive diagnosis of pancreatic acinar cell carcinoma. Compared with pancreatic ductal adenocarcinoma, pancreatic acinar cell carcinoma has a more favourable prognosis. Although radical surgery is recommended for patients with pancreatic acinar cell carcinoma who do not have distant metastases, the recurrence rate is high. The effectiveness of adjuvant therapy for pancreatic acinar cell carcinoma is unclear. The response to FOLFIRINOX is generally favourable, and some patients achieve a complete response. Pancreatic acinar cell carcinoma has a different genomic profile compared with pancreatic ductal adenocarcinoma. Although genomic analyses have shown that pancreatic acinar cell carcinoma rarely has KRAS, TP53 and CDKN2A mutations, it has a higher prevalence of homologous recombination-related genes, including BRCA1/2 and ATM, than pancreatic ductal adenocarcinoma, suggesting high sensitivity to platinum-containing regimens and PARP inhibitors. Targeted therapies for genomic alternations are beneficial. Therefore, genetic testing is important for patients with pancreatic acinar cell carcinoma to choose the optimal therapeutic strategy.

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“…MANEC immunohistochemically expresses both neuroendocrine and exocrine markers ( 23 , 65 , 66 ). The clinicopathological behaviour of MANEC is similar to that of PACC ( 23 , 64 , 67 ).…”

Section: Epidemiology Clinical Features Diagnosis Molecular Features ...mentioning

confidence: 68%

Comprehensive review of pancreatic acinar cell carcinoma: epidemiology, diagnosis, molecular features and treatment

Ikezawa,

Urabe,

Kai

et al. 2023

Japanese Journal of Clinical Oncology

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“…Based on reported cases (Table 1), this suggests that the clinical diagnosis of pancreatic MiNEN remains a big challenge. Niiya et al [29] reported several cases of successful preoperative diagnosis of MiNEN with EUS-FNA. Among these, a definitive diagnosis of tumors with size ≤ 11 mm was rare.…”

Section: Discussionmentioning

confidence: 99%

“…All reports of successful MiNEN diagnosis preoperatively using EUS-FNA were stained for both acinar and neuroendocrine markers. However, cases in which MiNEN was not diagnosed were stained only for either acinar or neuroendocrine markers [29]. They suggested that thorough immunostaining can help diagnose MiNEN.…”

Section: Discussionmentioning

confidence: 99%

Mixed neuroendocrine non-neuroendocrine neoplasm: a case report and review

Hiroi

Yamamoto

Hamaoka

et al. 2021

Clin J Gastroenterol

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Mixed neuroendocrine non-neuroendocrine neoplasm (MiNEN) of the pancreas is a rare entity, and obtaining a preoperative diagnosis is difficult. We present a 70-year-old man in whom the possibility of MiNEN was successfully discovered preoperatively by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Immunostaining revealed positive results for the neuroendocrine markers chromogranin A and synaptophysin. We considered the possibility for MiNEN before surgery. He underwent distal pancreatectomy with splenectomy. Immunohistochemical examination of the tumor cells showed a wide range of positivity for trypsin as well as for chromogranin A and synaptophysin. Considering that ≥ 30% tumors ware positive for both acinar and neuroendocrine markers, the patient was diagnosed with MiNEN. MiNEN is a malignant tumor that requires early detection and treatment but is a rare disease for which no method has been established. We found that EUS-FNA and immunostaining are effective diagnostic methods for MiNEN.

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Pancreatic mixed acinar–neuroendocrine carcinoma in a patient with a germline BRCA2 mutation: a case report

Ikeda

Miura

Kaneda

et al. 2022

Clin J Gastroenterol

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A case of pancreatic mixed acinar–neuroendocrine carcinoma successfully diagnosed with endoscopic ultrasound-guided fine needle aspiration

Cited by 4 publications

References 21 publications

Comprehensive review of pancreatic acinar cell carcinoma: epidemiology, diagnosis, molecular features and treatment

Comprehensive review of pancreatic acinar cell carcinoma: epidemiology, diagnosis, molecular features and treatment

Mixed neuroendocrine non-neuroendocrine neoplasm: a case report and review

Pancreatic mixed acinar–neuroendocrine carcinoma in a patient with a germline BRCA2 mutation: a case report

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