Misunderstood Gastric Perforation of a Pancreatic Acinar Cell Carcinoma: A Wolf in Sheep’s Clothing
A 70-year-old man was admitted to the Emergency Department (ED) for marked asthenia and severe anemia. In addition, a high level of lipase was found. During hospitalization, a locally advanced gastric cancer was diagnosed, with endoscopic evidence of a large polyploid formation originating under the...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Surgeries |
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| Online Access: | https://www.mdpi.com/2673-4095/4/1/9 |
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| author | Manuela Cuoghi Cinzia Baccaro Noemi Zorzetti Adele Fornelli Francesco Ferrara Vincenzo Cennamo Giuseppe Giovanni Navarra |
| author_facet | Manuela Cuoghi Cinzia Baccaro Noemi Zorzetti Adele Fornelli Francesco Ferrara Vincenzo Cennamo Giuseppe Giovanni Navarra |
| author_sort | Manuela Cuoghi |
| collection | DOAJ |
| description | A 70-year-old man was admitted to the Emergency Department (ED) for marked asthenia and severe anemia. In addition, a high level of lipase was found. During hospitalization, a locally advanced gastric cancer was diagnosed, with endoscopic evidence of a large polyploid formation originating under the cardias that occupied most of the gastric lumen. A total body CT scan was performed before surgery; the tumor affected the posterior gastric wall, with tenacious infiltration of the pancreatic body. Therefore, we performed a total gastrectomy with esophageal jejunum anastomosis and reconstruction of intestinal continuity according to Roux, distal spleno-pancreatectomy, and cholecystectomy. At histology, a pancreatic acinar cell carcinoma (PACC) with full thickness infiltration of the gastric wall was diagnosed. Acinar cell carcinomas are highly aggressive neoplasms, and surgical resection, when feasible, is the treatment of choice regardless of size, also because the role of neoadjuvant or adjuvant chemo- or radiotherapy remains uncodified. |
| first_indexed | 2024-03-11T05:54:01Z |
| format | Article |
| id | doaj.art-12ae791bd3ab4227b9aaf8ee699d7fe4 |
| institution | Directory Open Access Journal |
| issn | 2673-4095 |
| language | English |
| last_indexed | 2024-03-11T05:54:01Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgeries |
| spelling | doaj.art-12ae791bd3ab4227b9aaf8ee699d7fe42023-11-17T13:54:42ZengMDPI AGSurgeries2673-40952023-02-0141738510.3390/surgeries4010009Misunderstood Gastric Perforation of a Pancreatic Acinar Cell Carcinoma: A Wolf in Sheep’s ClothingManuela Cuoghi0Cinzia Baccaro1Noemi Zorzetti2Adele Fornelli3Francesco Ferrara4Vincenzo Cennamo5Giuseppe Giovanni Navarra6Department of General Surgery, Ospedale Civile A. Costa, 40046 Bologna, ItalyDepartment of General Surgery, Ospedale Civile A. Costa, 40046 Bologna, ItalyDepartment of General Surgery, Ospedale Civile A. Costa, 40046 Bologna, ItalyDepartment of Anatomic Pathology, Maggiore Hospital, 40133 Bologna, ItalyDepartment of Gastroenterology, Maggiore Hospital, 40133 Bologna, ItalyDepartment of Gastroenterology, Maggiore Hospital, 40133 Bologna, ItalyDepartment of General Surgery, Ospedale Civile A. Costa, 40046 Bologna, ItalyA 70-year-old man was admitted to the Emergency Department (ED) for marked asthenia and severe anemia. In addition, a high level of lipase was found. During hospitalization, a locally advanced gastric cancer was diagnosed, with endoscopic evidence of a large polyploid formation originating under the cardias that occupied most of the gastric lumen. A total body CT scan was performed before surgery; the tumor affected the posterior gastric wall, with tenacious infiltration of the pancreatic body. Therefore, we performed a total gastrectomy with esophageal jejunum anastomosis and reconstruction of intestinal continuity according to Roux, distal spleno-pancreatectomy, and cholecystectomy. At histology, a pancreatic acinar cell carcinoma (PACC) with full thickness infiltration of the gastric wall was diagnosed. Acinar cell carcinomas are highly aggressive neoplasms, and surgical resection, when feasible, is the treatment of choice regardless of size, also because the role of neoadjuvant or adjuvant chemo- or radiotherapy remains uncodified.https://www.mdpi.com/2673-4095/4/1/9pancreatic acinar cell carcinomapancreatic tumorgastric perforationgastric tumor |
| spellingShingle | Manuela Cuoghi Cinzia Baccaro Noemi Zorzetti Adele Fornelli Francesco Ferrara Vincenzo Cennamo Giuseppe Giovanni Navarra Misunderstood Gastric Perforation of a Pancreatic Acinar Cell Carcinoma: A Wolf in Sheep’s Clothing Surgeries pancreatic acinar cell carcinoma pancreatic tumor gastric perforation gastric tumor |
| title | Misunderstood Gastric Perforation of a Pancreatic Acinar Cell Carcinoma: A Wolf in Sheep’s Clothing |
| title_full | Misunderstood Gastric Perforation of a Pancreatic Acinar Cell Carcinoma: A Wolf in Sheep’s Clothing |
| title_fullStr | Misunderstood Gastric Perforation of a Pancreatic Acinar Cell Carcinoma: A Wolf in Sheep’s Clothing |
| title_full_unstemmed | Misunderstood Gastric Perforation of a Pancreatic Acinar Cell Carcinoma: A Wolf in Sheep’s Clothing |
| title_short | Misunderstood Gastric Perforation of a Pancreatic Acinar Cell Carcinoma: A Wolf in Sheep’s Clothing |
| title_sort | misunderstood gastric perforation of a pancreatic acinar cell carcinoma a wolf in sheep s clothing |
| topic | pancreatic acinar cell carcinoma pancreatic tumor gastric perforation gastric tumor |
| url | https://www.mdpi.com/2673-4095/4/1/9 |
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