Curative resection of a primarily unresectable acinar cell carcinoma of the pancreas after chemotherapy
<p>Abstract</p> <p>Background</p> <p>Acinar cell carcinoma (ACC) represents only 1–2% of pancreatic cancers and is a very rare malignancy. At the time of diagnosis only 50% of the tumors appear to be resectable. Reliable data for an effective adjuvant or neoadjuvant tre...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2009-02-01
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| Series: | World Journal of Surgical Oncology |
| Online Access: | http://www.wjso.com/content/7/1/22 |
| _version_ | 1818758598660980736 |
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| author | Dobrowolski Frank Stroszczynski Christian Dittert Dag D Rückert Felix Distler Marius Kersting Stephan Grützmann Robert |
| author_facet | Dobrowolski Frank Stroszczynski Christian Dittert Dag D Rückert Felix Distler Marius Kersting Stephan Grützmann Robert |
| author_sort | Dobrowolski Frank |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Acinar cell carcinoma (ACC) represents only 1–2% of pancreatic cancers and is a very rare malignancy. At the time of diagnosis only 50% of the tumors appear to be resectable. Reliable data for an effective adjuvant or neoadjuvant treatment are not available.</p> <p>Case presentation</p> <p>A 65-year old male presented with obstructive jaundice and non-specific upper abdominal pain. MRI-imaging showed a tumor within the head of the pancreas concomitant with Serum-Lipase and CA19-9. During ERCP, a stent was placed. Endosonographic fine needle biopsy confirmed an acinar cell carcinoma. Laparotomy presented an locally advanced tumor with venous infiltration that was consequently deemed unresectable. The patient was treated with five cycles of 5-FU monotherapy with palliative intention. Chemotherapy was well tolerated, and no severe complications were observed. Twelve months later, the patient was in stable condition, and CT-scanning showed an obvious reduction in the size of the tumor. During further operative exploration, a PPPD with resection of the portal vein was performed. Histopathological examination gave evidence of a diffuse necrotic ACC-tumor, all resection margins were found to be negative. Eighteen months later, the patient showed no signs of recurrent disease.</p> <p>Conclusion</p> <p>ACC responded well to 5-FU monochemotherapy. Therefore, neoadjuvant chemotherapy could be an option to reduce a primarily unresectable ACC to a point where curative resection can be achieved.</p> |
| first_indexed | 2024-12-18T06:29:23Z |
| format | Article |
| id | doaj.art-18258538b8234c35a8a9f8789c5178c4 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-18T06:29:23Z |
| publishDate | 2009-02-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-18258538b8234c35a8a9f8789c5178c42022-12-21T21:17:56ZengBMCWorld Journal of Surgical Oncology1477-78192009-02-01712210.1186/1477-7819-7-22Curative resection of a primarily unresectable acinar cell carcinoma of the pancreas after chemotherapyDobrowolski FrankStroszczynski ChristianDittert Dag DRückert FelixDistler MariusKersting StephanGrützmann Robert<p>Abstract</p> <p>Background</p> <p>Acinar cell carcinoma (ACC) represents only 1–2% of pancreatic cancers and is a very rare malignancy. At the time of diagnosis only 50% of the tumors appear to be resectable. Reliable data for an effective adjuvant or neoadjuvant treatment are not available.</p> <p>Case presentation</p> <p>A 65-year old male presented with obstructive jaundice and non-specific upper abdominal pain. MRI-imaging showed a tumor within the head of the pancreas concomitant with Serum-Lipase and CA19-9. During ERCP, a stent was placed. Endosonographic fine needle biopsy confirmed an acinar cell carcinoma. Laparotomy presented an locally advanced tumor with venous infiltration that was consequently deemed unresectable. The patient was treated with five cycles of 5-FU monotherapy with palliative intention. Chemotherapy was well tolerated, and no severe complications were observed. Twelve months later, the patient was in stable condition, and CT-scanning showed an obvious reduction in the size of the tumor. During further operative exploration, a PPPD with resection of the portal vein was performed. Histopathological examination gave evidence of a diffuse necrotic ACC-tumor, all resection margins were found to be negative. Eighteen months later, the patient showed no signs of recurrent disease.</p> <p>Conclusion</p> <p>ACC responded well to 5-FU monochemotherapy. Therefore, neoadjuvant chemotherapy could be an option to reduce a primarily unresectable ACC to a point where curative resection can be achieved.</p>http://www.wjso.com/content/7/1/22 |
| spellingShingle | Dobrowolski Frank Stroszczynski Christian Dittert Dag D Rückert Felix Distler Marius Kersting Stephan Grützmann Robert Curative resection of a primarily unresectable acinar cell carcinoma of the pancreas after chemotherapy World Journal of Surgical Oncology |
| title | Curative resection of a primarily unresectable acinar cell carcinoma of the pancreas after chemotherapy |
| title_full | Curative resection of a primarily unresectable acinar cell carcinoma of the pancreas after chemotherapy |
| title_fullStr | Curative resection of a primarily unresectable acinar cell carcinoma of the pancreas after chemotherapy |
| title_full_unstemmed | Curative resection of a primarily unresectable acinar cell carcinoma of the pancreas after chemotherapy |
| title_short | Curative resection of a primarily unresectable acinar cell carcinoma of the pancreas after chemotherapy |
| title_sort | curative resection of a primarily unresectable acinar cell carcinoma of the pancreas after chemotherapy |
| url | http://www.wjso.com/content/7/1/22 |
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