Abstract
A 74-year-old man was admitted to Ogaki Municipal Hospital with a chief complaint of anemia. Abdominal enhanced CT showed 13 cm expansive growing tumor in the left upper abdomen. The borderline between the pancreas body and the tumor was unclear and the dilatation of the main pancreatic duct was seen. In the portal vein, filling defect suspected of tumor thrombus was seen. MRCP showed interruption and dilatation of the main pancreatic duct. Given these, we diagnosed acinar cell carcinoma or endocrine tumor of the pancreas with tumor thrombus extending into the portal vein and distal pancreatectomy with portal vein replacement, right hemicolectomy and jejunectomy was performed. Pathological diagnosis was acinar cell carcinoma. During follow up, multiple liver metastases was found after 3 months. We treated this by systemic chemotherapy of Gemcitabine or S-1 but he died of cancer after 9 months. Patients with acinar cell carcinoma extending into the portal vein have poor prognosis and need to be treated by chemotherapy after surgery, however, standard treatment has not yet been established.
