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AFP-producing acinar cell carcinoma treated by pancreaticoduodenectomy in a patient with a previous radical subtotal gastrectomy by gastric cancer.

Kim CY, Lee SH, Jeon HM, Kim HK, Kang CM, Lee WJ - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: The Adenosine triphosphate-based chemotherapy response assay (ATP-CRA) suggested that cisplatin would be more desirable than gemcitabine in AFP-producing ACC of the pancreas as an adjuvant chemotherapy.However, the adjuvant chemotherapy was not performed due to the early pathological stage.The patient died from carcinomatosis and pneumonia.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
We report a case of alpha-fetoprotein (AFP)-producing acinar cell carcinoma (ACC) of the pancreas. The tumor was diagnosed in a 72 yearold female after radical subtotal gastrectomy (Billroth I) due to early gastric cancer six months before. The initial serum AFP levels were increased to 2,254.1 IU/ml and preoperative imaging studies showed a mass with approximately 2.5 cm in diameter near the neck of the pancreas. A pancreaticoduodenectomy was performed. The pathologic examination revealed an ill-defined lobulating tumor confined to the pancreas (T1 stage). Immunohistochemical study showed that the tumor cells expressed AFP. The Adenosine triphosphate-based chemotherapy response assay (ATP-CRA) suggested that cisplatin would be more desirable than gemcitabine in AFP-producing ACC of the pancreas as an adjuvant chemotherapy. However, the adjuvant chemotherapy was not performed due to the early pathological stage. The patient died from carcinomatosis and pneumonia. Even if the tumor was on a relatively early stage, an adjuvant treatment should be considered ACC.

No MeSH data available.


Related in: MedlinePlus

Surgical pathology and postoperative course. An about 1.9 cm-sized pancreas-confining lobulated tumor was noted on the neck of the pancreas (A). The tumor cells are arranged in irregular solid sheets and acinar pattern (B, ×100), The AFP immunohistochemical staining was diffuse positive in tumor cells (C, ×100). The patient got no adjuvant chemotherapy in follow up. The serial follow up of serum AFP showed re-elevation after declining near the normal level following operation (D). H&E, hematoxylin-eosin.
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Figure 3: Surgical pathology and postoperative course. An about 1.9 cm-sized pancreas-confining lobulated tumor was noted on the neck of the pancreas (A). The tumor cells are arranged in irregular solid sheets and acinar pattern (B, ×100), The AFP immunohistochemical staining was diffuse positive in tumor cells (C, ×100). The patient got no adjuvant chemotherapy in follow up. The serial follow up of serum AFP showed re-elevation after declining near the normal level following operation (D). H&E, hematoxylin-eosin.

Mentions: An 1.9×1.7 cm-sized ill-defined lobulating tumor confined to the pancreas was revealed in the macroscopic specimen examination (Fig. 3A). An AFP-producing ACC of the pancreas (T1 stage) was classified based on the routine hematoxylin and eosin (H&E) staining and immunohistochemical staining (Fig. 3B and 3C).


AFP-producing acinar cell carcinoma treated by pancreaticoduodenectomy in a patient with a previous radical subtotal gastrectomy by gastric cancer.

Kim CY, Lee SH, Jeon HM, Kim HK, Kang CM, Lee WJ - Korean J Hepatobiliary Pancreat Surg (2014)

Surgical pathology and postoperative course. An about 1.9 cm-sized pancreas-confining lobulated tumor was noted on the neck of the pancreas (A). The tumor cells are arranged in irregular solid sheets and acinar pattern (B, ×100), The AFP immunohistochemical staining was diffuse positive in tumor cells (C, ×100). The patient got no adjuvant chemotherapy in follow up. The serial follow up of serum AFP showed re-elevation after declining near the normal level following operation (D). H&E, hematoxylin-eosin.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492330&req=5

Figure 3: Surgical pathology and postoperative course. An about 1.9 cm-sized pancreas-confining lobulated tumor was noted on the neck of the pancreas (A). The tumor cells are arranged in irregular solid sheets and acinar pattern (B, ×100), The AFP immunohistochemical staining was diffuse positive in tumor cells (C, ×100). The patient got no adjuvant chemotherapy in follow up. The serial follow up of serum AFP showed re-elevation after declining near the normal level following operation (D). H&E, hematoxylin-eosin.
Mentions: An 1.9×1.7 cm-sized ill-defined lobulating tumor confined to the pancreas was revealed in the macroscopic specimen examination (Fig. 3A). An AFP-producing ACC of the pancreas (T1 stage) was classified based on the routine hematoxylin and eosin (H&E) staining and immunohistochemical staining (Fig. 3B and 3C).

Bottom Line: The Adenosine triphosphate-based chemotherapy response assay (ATP-CRA) suggested that cisplatin would be more desirable than gemcitabine in AFP-producing ACC of the pancreas as an adjuvant chemotherapy.However, the adjuvant chemotherapy was not performed due to the early pathological stage.The patient died from carcinomatosis and pneumonia.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
We report a case of alpha-fetoprotein (AFP)-producing acinar cell carcinoma (ACC) of the pancreas. The tumor was diagnosed in a 72 yearold female after radical subtotal gastrectomy (Billroth I) due to early gastric cancer six months before. The initial serum AFP levels were increased to 2,254.1 IU/ml and preoperative imaging studies showed a mass with approximately 2.5 cm in diameter near the neck of the pancreas. A pancreaticoduodenectomy was performed. The pathologic examination revealed an ill-defined lobulating tumor confined to the pancreas (T1 stage). Immunohistochemical study showed that the tumor cells expressed AFP. The Adenosine triphosphate-based chemotherapy response assay (ATP-CRA) suggested that cisplatin would be more desirable than gemcitabine in AFP-producing ACC of the pancreas as an adjuvant chemotherapy. However, the adjuvant chemotherapy was not performed due to the early pathological stage. The patient died from carcinomatosis and pneumonia. Even if the tumor was on a relatively early stage, an adjuvant treatment should be considered ACC.

No MeSH data available.


Related in: MedlinePlus