PDF(Pubmed)
Abstract：
Pancreatic acinar cell carcinoma is rare; it accounts for 1% of all malignant pancreatic exocrine tumors. Although surgical resection is an option for curative treatment, the safety and efficacy of conversion surgery in patients with pancreatic acinar cell carcinoma with metastasis remain unknown.
A 67-year-old man with epigastric pain and a pancreatic tumor was referred to our hospital. Computed tomography revealed a large tumor with a maximum diameter of 67 mm at the pancreatic head and a 23-mm mass in the left upper abdominal cavity. Because a definitive diagnosis could not be made based on endoscopic ultrasonography-guided fine needle aspiration biopsy findings, a diagnostic laparoscopy was performed. The tumor in the greater omentum at the left upper abdomen, resected under laparoscopy, was histopathologically diagnosed as pancreatic acinar cell carcinoma. Therefore, the pancreatic tumor was diagnosed as an unresectable pancreatic acinar cell carcinoma with a solitary peritoneal dissemination. The size of the main pancreatic tumor decreased to 15 mm after 18 courses of FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin). Subsequently, the patient underwent conversion surgery, and the initial diagnosis of pancreatic acinar cell carcinoma was confirmed on pathological examination. The patient was discharged 31 days postoperatively, following which he received adjuvant chemotherapy with S-1. No sign of recurrence has been observed for 32 months after surgical resection.
FOLFIRINOX may be effective in patients with pancreatic acinar cell carcinoma, and conversion surgery after FOLFIRINOX may be applicable to selective patients.
A 67-year-old man with epigastric pain and a pancreatic tumor was referred to our hospital. Computed tomography revealed a large tumor with a maximum diameter of 67 mm at the pancreatic head and a 23-mm mass in the left upper abdominal cavity. Because a definitive diagnosis could not be made based on endoscopic ultrasonography-guided fine needle aspiration biopsy findings, a diagnostic laparoscopy was performed. The tumor in the greater omentum at the left upper abdomen, resected under laparoscopy, was histopathologically diagnosed as pancreatic acinar cell carcinoma. Therefore, the pancreatic tumor was diagnosed as an unresectable pancreatic acinar cell carcinoma with a solitary peritoneal dissemination. The size of the main pancreatic tumor decreased to 15 mm after 18 courses of FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin). Subsequently, the patient underwent conversion surgery, and the initial diagnosis of pancreatic acinar cell carcinoma was confirmed on pathological examination. The patient was discharged 31 days postoperatively, following which he received adjuvant chemotherapy with S-1. No sign of recurrence has been observed for 32 months after surgical resection.
FOLFIRINOX may be effective in patients with pancreatic acinar cell carcinoma, and conversion surgery after FOLFIRINOX may be applicable to selective patients.
摘要：
胰腺腺泡细胞癌很少见；它占所有恶性胰腺外分泌肿瘤的1％。虽然手术切除是治愈性治疗的一种选择，胰腺腺泡细胞癌转移患者行转化手术的安全性和有效性尚不清楚.
一名67岁的患者患有上腹痛和胰腺肿瘤，被转诊到我们医院。计算机断层扫描显示一个大肿瘤，胰头最大直径为67毫米，左上腹腔有23毫米的肿块。由于无法根据超声内镜引导的细针穿刺活检结果做出明确诊断，进行了诊断性腹腔镜检查.左上腹部大网膜肿瘤,在腹腔镜下切除，经组织病理学诊断为胰腺腺泡细胞癌。因此,胰腺肿瘤被诊断为不可切除的胰腺腺泡细胞癌，伴有孤立的腹膜播散。18个疗程的FOLFIRINOX（5-氟尿嘧啶，亚叶酸,伊立替康,和奥沙利铂）。随后，病人接受了转换手术,病理检查证实胰腺腺泡细胞癌。患者术后31天出院，随后他接受了S-1辅助化疗。手术切除后32个月未观察到复发迹象。
FOLFIRINOX可能对胰腺腺泡细胞癌患者有效，FOLFIRINOX后的转换手术可能适用于选择性患者。
一名67岁的患者患有上腹痛和胰腺肿瘤，被转诊到我们医院。计算机断层扫描显示一个大肿瘤，胰头最大直径为67毫米，左上腹腔有23毫米的肿块。由于无法根据超声内镜引导的细针穿刺活检结果做出明确诊断，进行了诊断性腹腔镜检查.左上腹部大网膜肿瘤,在腹腔镜下切除，经组织病理学诊断为胰腺腺泡细胞癌。因此,胰腺肿瘤被诊断为不可切除的胰腺腺泡细胞癌，伴有孤立的腹膜播散。18个疗程的FOLFIRINOX（5-氟尿嘧啶，亚叶酸,伊立替康,和奥沙利铂）。随后，病人接受了转换手术,病理检查证实胰腺腺泡细胞癌。患者术后31天出院，随后他接受了S-1辅助化疗。手术切除后32个月未观察到复发迹象。
FOLFIRINOX可能对胰腺腺泡细胞癌患者有效，FOLFIRINOX后的转换手术可能适用于选择性患者。
