A case of acinar cell carcinoma of the pancreas that formed extensive tumor thrombus of the portal vein

Igarashi, Hiroaki; Shinozaki, Sachiko; Mukada, Takeo

doi:10.1007/s12328-008-0044-x

Cited by 6 publications

(3 citation statements)

References 31 publications

(42 reference statements)

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“…There have been only a few case reports of ACC accompanying tumor thrombus in the portal vein, superior mesenteric vein, and splenic vein. [ 3 , 6 , 7 , 29 , 37 , 38 ] It is important to differentiate tumor thrombus from blood thrombus because therapeutic strategy and prognosis varies. In our case, although we could not obtain tissue from the tumor in the portal vein, the compatible FDG uptake of the thrombus with the primary tumor, and the contiguous nature of the extension from the pancreatic primary tumor support the conclusion of tumor thrombus.…”

Section: Discussionmentioning

confidence: 99%

Acinar cell carcinoma of the pancreas presenting as diffuse pancreatic enlargement

Luo

Hu²,

Ma³

et al. 2017

Medicine

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Rationale:Pancreatic acinar cell carcinoma (ACC) is a rare malignant tumor of exocrine pancreas. It is typically a well-marginated large solid mass arising in a certain aspect of the pancreas. Diffuse involvement of ACC in the pancreas is very rare, and may simulate pancreatitis in radiological findings. We report 2 cases of ACC presenting as diffuse enlargement of the pancreas due to tumor involvement without formation of a distinct mass.Patient concerns:The patients consisted of a 41-year-old man with weight loss and a 77-year-old man who was asymptomatic.Diagnoses:Computed tomography (CT) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT showed diffuse enlargement of the pancreas forming a sausage-like shape with homogenously increased FDG activity.Interventions:Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) biopsy of the pancreatic lesion was performed.Outcomes:Histopathology results from the pancreas confirmed the diagnosis of pancreatic ACC.Lessons:Because diffuse enlargement of the pancreas is a common imaging feature of pancreatitis, recognition of this rare morphologic pattern of ACC is important for radiological diagnosis of this tumor.

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Section: Discussionmentioning

confidence: 99%

Acinar cell carcinoma of the pancreas presenting as diffuse pancreatic enlargement

Luo

Hu²,

Ma³

et al. 2017

Medicine

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“…However, intrinsic venous obstruction by tumor thrombus, while a common occurrence in hepatocellular carcinoma, rarely occurs in pancreatic cancer [16]. Indeed, there have been only a few cases of pancreatic cancer with portal vein tumor thrombus, including two cases of ACC accompanied by tumor thrombus [15, 16]. Furthermore, distinguishing tumor thrombus from a blood clot is very important, because it is well recognized that a tumor thrombus involving the mesenteric venous system is associated with liver metastases.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, ACC accompanied by tumor thrombus is very rare. In the English literature, there have been only two reports of ACC with portal vein tumor thrombus [15, 16]. …”

Section: Introductionmentioning

confidence: 99%

Primary pancreatic-type acinar cell carcinoma of the jejunum with tumor thrombus extending into the mesenteric venous system: a case report and literature review

et al. 2017

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BackgroundAlthough ectopic pancreatic tissue is common in the upper gastrointestinal tract, the incidence of ectopic pancreatic tissue in the jejunum is low, and malignant transformation in ectopic pancreatic tissue is rare. Furthermore, pancreatic-type acinar cell carcinoma (ACC) developing in the jejunum and ACC accompanied by tumor thrombus are extremely rare.Case presentationA 78-year-old-woman presented with melena. Abdominal computed tomography images and endoscopic examination revealed a submucosal jejunal mass with tumor thrombus extending into a jejunal vein. The patient underwent a curative resection combined with a partial jejunectomy and partial pancreatectomy. Histopathological examination of the resected tissue showed tumor cells with a homogeneous acinar architecture identical to pancreatic-type ACC and tumor thrombus. Postoperatively, she was followed for 10 months and had no recurrence.ConclusionWe present an extremely rare case of pancreatic-type ACC in the jejunum with extensive tumor thrombus invading into the mesenteric venous system. This type of cancer has not been reported previously but should be considered in the differential diagnosis of a jejunal mass.

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Tumor thrombosis: a peculiar finding associated with pancreatic neuroendocrine neoplasms. A pictorial essay

Robertis

Paiella²,

Cardobi

et al. 2017

Abdom Radiol

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While abutment, encasement or vessel occlusion are identified in most patients with a pancreatic tumor, tumor thrombosis is an uncommon finding. In particular, there are no description in the literature of tumor thrombosis associated with ductal adenocarcinoma, the most common pancreatic tumor. On the other hand, surgical series reveal that tumor thrombosis is associated with about 5% of pancreatic neuroendocrine neoplasms (PanNENs), and literature data suggest that this finding is frequently underreported on pre-operative imaging examinations. Tumor thrombosis may be clinically relevant, causing splenoportomesenteric hypertension, possibly responsible for life-threatening upper gastrointestinal bleeding. Bland thrombosis caused by direct infiltration of peri-pancreatic vessels frequently determines surgical unresectability, even in neuroendocrine tumors; on the opposite, tumor thrombosis associated with PanNENs do not exclude surgery per se, even though both morbidity and mortality can be increased by such condition. Considering the favorable prognosis of PanNENs and the frequent need to treat tumor thrombosis in order to prevent complications or to relieve symptoms, it is of paramount importance for radiologists the knowledge of the variety of findings associated with tumor thrombosis in PanNENs.

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A case of acinar cell carcinoma of the pancreas that formed extensive tumor thrombus of the portal vein

Cited by 6 publications

References 31 publications

Acinar cell carcinoma of the pancreas presenting as diffuse pancreatic enlargement

Acinar cell carcinoma of the pancreas presenting as diffuse pancreatic enlargement

Primary pancreatic-type acinar cell carcinoma of the jejunum with tumor thrombus extending into the mesenteric venous system: a case report and literature review

Tumor thrombosis: a peculiar finding associated with pancreatic neuroendocrine neoplasms. A pictorial essay

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