2005 Volume 38 Issue 12 Pages 1821-1827
We report a rare case of pancreatic cancer, duct-acinar cell carcinoma. The tumor was detected on CT in the pancreatic head of a 63-year-old man who had aggravated diabetes mellitus. Enhanced CT showed a solid tumor with an indistinct border and hypovascularity, 3.5cm in diameter. Angiography showed direct invasion to the iliocecal vein. ERP showed a disrupted main pancreatic duct. Laboratory findings were unremarkable, except for serum CEA of 5.6ng/ml and hyperglycemia. With a diagnosis of ductal invasive cancer of the pancreatic head, we conducted pancreatoduodenectomy with resection of the iliocecal vein and intraoperative radio- therapy. Histopathological examination showed that the tumor consisted of two distinct cell populations: duct and acinar cells. According to immunohistochemical analysis, duct cells were positive for CEA, whereas acinar cells were positive for amylase, trypsin, and alpha-1-antitrypsin. Both were negative for chromogranin A. These findings suggested mixed duct-acinar carcinoma of the pancreas, a very rare occurrence whose clinical and pathological features are little known. Further cases and studies are thus needed to clarify its pathogenesis.
