Abstract：
Pancreatic acinar cell carcinoma (PACC) is a very rare subtype of pancreatic cancer. Due to small number of patients, no standard chemotherapy protocol has been established. We experienced an extremely rare case of PACC with liver metastasis that showed a pathological complete response after modified FOLFIRINOX (mFFX) therapy. A 42-year-old man who underwent distal pancreatectomy for an 80 mm tumor at the pancreatic tail 3 years ago was referred to our hospital in September 2017 for the treatment of a recurrent liver tumor. Percutaneous biopsy revealed an acinar-neuroendocrine carcinoma, similar to the surgical specimen. He received eight cycles of irinotecan plus cisplatin chemotherapy. However, the tumor increased in size, and treatment was switched to mFFX therapy. The tumor in the liver shrank remarkably after nine cycles of mFFX therapy. Conversion surgery was selected, and the patient underwent hepatic left and caudate lobectomy 8 months after administration of mFFX. The resected specimen showed no viable tumor cells, indicating a pathological complete response. The histological diagnosis was reconsidered, and PACC was finally diagnosed via an additional immunohistological review. The patient has remained well with no recurrence for 6 years after surgery. This study is the first to report a case of pathological complete response with mFFX therapy for the recurrence of PACC.
摘要：
胰腺腺泡细胞癌（PACC）是一种非常罕见的胰腺癌亚型。由于患者数量少,尚未建立标准化疗方案.我们经历了一例极为罕见的PACC肝转移病例，在改良FOLFIRINOX（mFFX）治疗后表现出病理完全缓解。2017年9月，一名42岁的男子因胰尾80mm肿瘤而接受了胰尾远端切除术，于2017年9月被转诊到我院治疗复发性肝肿瘤。经皮活检显示腺泡神经内分泌癌，类似于手术标本。他接受了八个周期的伊立替康加顺铂化疗。然而,肿瘤增大了,治疗改为mFFX治疗。经过9个周期的mFFX治疗，肝脏肿瘤明显缩小。选择了转换手术，患者在给予mFFX后8个月接受了左肝和尾状叶切除术。切除的标本显示没有活的肿瘤细胞，表明病理完全反应。组织学诊断被重新考虑，PACC最终通过额外的免疫组织学检查被诊断出来。患者在手术后6年内一直保持良好状态，无复发。本研究首次报道了一例pACC复发的mFFX治疗病理完全缓解的病例。
