Acinar Cell Carcinoma of the Pancreas with Colon Involvement

We report a case of acinar cell carcinoma of the pancreas with colon involvement that was difficult to distinguish from primary colon cancer. A 60-year-old man was admitted with a 1-month history of diarrhea. Contrast-enhanced computed tomography (CT) revealed a large tumor (10.6 × 11.6 cm) at the s...

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Main Authors:	Asayama, Naoki, Kojima, Yasushi, Aoki, Tomonori, Maeyashiki, Chiaki, Yokoi, Chizu, Yanase, Mikio, Suda, Ryuichiro, Yano, Hideaki, Nakamura, Harumi, Igari, Toru
Format:	Online
Language:	English
Published:	Hindawi Publishing Corporation 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3914318/

id	pubmed-3914318
recordtype	oai_dc
spelling	pubmed-39143182014-02-18 Acinar Cell Carcinoma of the Pancreas with Colon Involvement Asayama, Naoki Kojima, Yasushi Aoki, Tomonori Maeyashiki, Chiaki Yokoi, Chizu Yanase, Mikio Suda, Ryuichiro Yano, Hideaki Nakamura, Harumi Igari, Toru Case Report We report a case of acinar cell carcinoma of the pancreas with colon involvement that was difficult to distinguish from primary colon cancer. A 60-year-old man was admitted with a 1-month history of diarrhea. Contrast-enhanced computed tomography (CT) revealed a large tumor (10.6 × 11.6 cm) at the splenic flexure of the colon. Colonoscopy showed completely round ulcerative lesions, and biopsy revealed poorly differentiated adenocarcinoma. Left hemicolectomy, resection of the jejunum and pancreas body and tail, and splenectomy were performed based on a diagnosis of descending colon cancer (cT4N0M0, stage IIB), and surgery was considered to be curative. Diagnosis was subsequently confirmed as moderately differentiated acinar cell carcinoma of the pancreas by immunohistochemical staining (pT3N0M0, stage IIA). Multiple liver metastases with portal thrombosis were found 8 weeks postoperatively. Despite combination chemotherapy with oral S-1 and gemcitabine, the patient died of hepatic failure with no effect of chemotherapy 14 weeks postoperatively. Correct diagnosis was difficult to determine preoperatively from the clinical, CT, and colonoscopy findings. Moreover, the disease was extremely aggressive even after curative resection. Physicians should consider pancreatic cancer in the differential diagnosis of similar cases. Hindawi Publishing Corporation 2014 2014-01-16 /pmc/articles/PMC3914318/ /pubmed/24550989 http://dx.doi.org/10.1155/2014/389425 Text en Copyright © 2014 Naoki Asayama et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Asayama, Naoki Kojima, Yasushi Aoki, Tomonori Maeyashiki, Chiaki Yokoi, Chizu Yanase, Mikio Suda, Ryuichiro Yano, Hideaki Nakamura, Harumi Igari, Toru
spellingShingle	Asayama, Naoki Kojima, Yasushi Aoki, Tomonori Maeyashiki, Chiaki Yokoi, Chizu Yanase, Mikio Suda, Ryuichiro Yano, Hideaki Nakamura, Harumi Igari, Toru Acinar Cell Carcinoma of the Pancreas with Colon Involvement
author_facet	Asayama, Naoki Kojima, Yasushi Aoki, Tomonori Maeyashiki, Chiaki Yokoi, Chizu Yanase, Mikio Suda, Ryuichiro Yano, Hideaki Nakamura, Harumi Igari, Toru
author_sort	Asayama, Naoki
title	Acinar Cell Carcinoma of the Pancreas with Colon Involvement
title_short	Acinar Cell Carcinoma of the Pancreas with Colon Involvement
title_full	Acinar Cell Carcinoma of the Pancreas with Colon Involvement
title_fullStr	Acinar Cell Carcinoma of the Pancreas with Colon Involvement
title_full_unstemmed	Acinar Cell Carcinoma of the Pancreas with Colon Involvement
title_sort	acinar cell carcinoma of the pancreas with colon involvement
description	We report a case of acinar cell carcinoma of the pancreas with colon involvement that was difficult to distinguish from primary colon cancer. A 60-year-old man was admitted with a 1-month history of diarrhea. Contrast-enhanced computed tomography (CT) revealed a large tumor (10.6 × 11.6 cm) at the splenic flexure of the colon. Colonoscopy showed completely round ulcerative lesions, and biopsy revealed poorly differentiated adenocarcinoma. Left hemicolectomy, resection of the jejunum and pancreas body and tail, and splenectomy were performed based on a diagnosis of descending colon cancer (cT4N0M0, stage IIB), and surgery was considered to be curative. Diagnosis was subsequently confirmed as moderately differentiated acinar cell carcinoma of the pancreas by immunohistochemical staining (pT3N0M0, stage IIA). Multiple liver metastases with portal thrombosis were found 8 weeks postoperatively. Despite combination chemotherapy with oral S-1 and gemcitabine, the patient died of hepatic failure with no effect of chemotherapy 14 weeks postoperatively. Correct diagnosis was difficult to determine preoperatively from the clinical, CT, and colonoscopy findings. Moreover, the disease was extremely aggressive even after curative resection. Physicians should consider pancreatic cancer in the differential diagnosis of similar cases.
publisher	Hindawi Publishing Corporation
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3914318/
_version_	1612055043260809216

Acinar Cell Carcinoma of the Pancreas with Colon Involvement

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