Mixed acinar-endocrine carcinoma of pancreas: a case report and brief review of the literature

Abstract

Mixed acinar-endocrine carcinoma (MAEC) of the pancreas is a rare entity. We present a 65-year-old Chinese female who was admitted with jaundice and nagging epigastric pain with intermittent diarrhea for 1 month. She eventually underwent abdominal magnetic resonance imaging, which showed an 8×6 cm mass in the head of the pancreas and showed two abnormal lesions in the liver simultaneously. MAEC of the pancreas with synchronous hepatic metastasis was confirmed with immunohistochemistry after Whipple operation and hepatic partial resection of the lesions. Postoperative recovery of this patient was uneventful, and no evidence of recurrence or metastasis was observed after 12 months of follow-up. MAEC of pancreas is thought to be extremely rare and lack of typical clinical symptoms. The prognosis is poor overall, but early detection with complete resection may be beneficial to patients.

Metastatic mixed acinar-endocrine carcinoma of the pancreas treated with a multidisciplinary approach: a case report

“…Some pancreatic neoplasms have significant components from more than one line of differentiation and are classified as mixed acinar-endocrine carcinomas (MAEC), mixed acinar-ductal carcinomas, mixed ductal-endocrine carcinomas, or mixed acinar-endocrine-ductal carcinomas [2]. By arbitrary definition, each component must comprise at least 25% of the neoplasm [3, 12]. Only 21 cases that fit this strict definition have been reported in the English literature.…”

“…This is the first report of a metastatic stomach tumour from pancreatic MAEC that was successfully treated with a multidisciplinary approach. To date, 12 cases of pancreatic MAEC that met criteria by the WHO classification have been reported in the English literature, which we identified by a PubMed search [3–10]. We review the literature and discuss the treatment for MAEC.…”

Preoperative Treatment With FOLFIRINOX and Successful Resection for a Patient With Mixed Acinar-Endocrine Carcinoma of the Pancreas

“…1 The criteria for diagnosis of MAEC is that more than 25% of each component of acinar and endocrine cells are present in the specimen. Immunohistochemistry demonstrates the presence of each component: trypsin, chymotrypsin, lipase, or periodic acid-Schiff as an acinar marker and chromogranin A, synaptophysin, CD56, or neuron-specific enolase as an endocrine marker.…”

“…2 Therefore, optimal treatment strategy is surgical resection if resectable for the localized disease, conforming to the treatment for pancreatic ductal adenocarcinoma or ACC. 1 Response to chemotherapy has reportedly been poor. 3 The median overall survival was calculated to be 12 months after surgical resection for the 21 cases with the information available from published papers.…”

“…3 The median overall survival was calculated to be 12 months after surgical resection for the 21 cases with the information available from published papers. 1 …”