672 patients with acinar cell carcinoma of the pancreas: a population-based comparison to pancreatic adenocarcinoma

Wisnoski, Nicholas C.; Townsend, Courtney M.; Nealon, William H.; Freeman, Jean L.; Riall, Taylor S.

doi:10.1016/j.surg.2008.03.006

Cited by 193 publications

(196 citation statements)

References 16 publications

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“…23,24 A large recent study showed an overall 5-year survival for pancreatic acinar cell carcinomas of 42.8% and a 5-year survival of 22% for those with unresected acinar cell carcinomas. 3 Our cases are also in line with a more favorable outcome, as none developed metastasis at a mean follow-up of 22 months and only one patient developed recurrent disease in the liver at 18 months.…”

Section: Discussionsupporting

confidence: 86%

“…The mean age of the patients (65 years) was slightly higher than that reported for pancreatic acinar cell carcinoma (58 years) and lower than the mean age for ductal adenocarcinoma (70 years). 1,3 Three main questions have to be addressed in conjunction with the four neoplasms observed: first, do these tumors really represent true acinar cell carcinomas of pancreatic type, or are they merely unusual acinar variants of cholangiocarcinoma, hepatocellular carcinoma or adult hepatoblastoma? Second, can we safely exclude a solitary liver metastasis from an occult pancreatic acinar cell carcinoma, and third, how can Pancreatic-type acinar cell carcinoma of the liver we explain the histogenesis of these neoplasms, if they indeed represent primary hepatic acinar cell carcinomas?…”

Section: Discussionmentioning

confidence: 99%

“…Another significant argument against a metastasis from a pancreatic primary is the fact that there was only one hepatic mass and not, as it is usually seen in metastatic pancreatic acinar cell carcinoma, multiple liver tumors. [1][2][3]5 Moreover, metastatic pancreatic acinar cell carcinomas are usually large and about 50% of the patients with pancreatic acinar cell carcinoma have at the time of initial diagnosis evidence of metastatic disease, outside the liver. [1][2][3]5 Regarding the histogenesis of hepatic acinar cell carcinoma, there is no ready answer as yet.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3]5 Moreover, metastatic pancreatic acinar cell carcinomas are usually large and about 50% of the patients with pancreatic acinar cell carcinoma have at the time of initial diagnosis evidence of metastatic disease, outside the liver. [1][2][3]5 Regarding the histogenesis of hepatic acinar cell carcinoma, there is no ready answer as yet. Previous reports of extra-pancreatic acinar cell carcinomas suggested an origin from heterotopic or metaplastic pancreatic tissue, and this could be demonstrated in some cases.…”

Section: Discussionmentioning

confidence: 99%

“…2 Besides their characteristic histological features, acinar cell carcinomas are defined on the basis of their immunohistochemical staining for pancreatic enzymes, notably trypsin. [3][4][5] There are few case reports on neoplasms with pancreatic acinar cell differentiation that occurred outside the pancreas, particularly in the gastrointestinal tract. [6][7][8] Some of these cases were found in or next to heterotopic 9,10 or metaplastic 11 pancreatic tissue that was considered a possible source of the tumor.…”

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confidence: 99%

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Pancreatic-type acinar cell carcinoma of the liver: a clinicopathologic study of four patients

et al. 2011

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Acinar cell carcinoma of pancreatic type rarely occurs at extra-pancreatic sites. We report four primary liver tumors with features of pancreatic acinar cell carcinoma. The patients were two males and two females with a mean age of 65 years (range, 49-72 years). They had upper abdominal pain, weight loss and/or an incidentally discovered liver mass. None had evidence of a primary pancreatic tumor. Grossly, the tumors were large (mean size, 12 cm), well circumscribed and showed a lobulated cut surface. Histologically, they showed a predominantly microacinar pattern, with occasional trabecular, solid and microcystic areas. Cellular atypia and mitotic activity varied within the same tumor and from tumor to tumor. Immunohistochemically, the tumor cells were positive for cytokeratin 18 and at least one acinar cell marker (ie, trypsin, amylase or lipase), but were negative for cytokeratins 7, 19 and 20, HepPar-1, AFP, CD10, carcinoembryonic antigen, CD56, Islet-1 and CDX2. Two tumors stained focally for synaptophysin and chromogranin A. Adjacent liver parenchyma displayed no evidence of cirrhosis. During a mean follow-up of 22 months (range, 3-38 months) no metastases occurred, but one patient developed local recurrence. Our study demonstrates that acinar cell carcinoma of pancreatic type may also originate from the liver and can be readily distinguished from other primary liver neoplasms by its distinct histological and immunohistochemical features. Because our cases were observed within a rather short period, it is likely that this tumor type is so far underrecognized and has been mistaken as a variant of hepatocellular carcinoma, cholangiocarcinoma or any other liver tumor.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%