Abstract
Acinar cell carcinomas (ACCs) of the pancreas are rare pancreatic neoplasms. At the time of detection, ACCs measuring less than 2cm are very uncommon.
When a 61-year-old female first visited a neighboring clinic, a low-echoic/low-attenuated mass in the body of the pancreas, 15mm in diameter, was detected by ultrasound (US)/enhanced CT. A return visit two years later showed that the mass increased to 3cm at which point the patient refused to undergo surgery. Three a half years after her first visit, she was seen in our institution and was informed that the mass had grown to 7cm. At this point she finally underwent surgery. We considered the tumor to be rather malignant, because she died with multiple liver metastases 5 months after the operation. The final histologic diagnosis, determined immunohistochemically, was mixed acinar-endocrine carcinoma of the pancreas.
Although a low-echoic/low-attenuated mass less than 2cm present, identified by US or CT and mimicking a cystic lesion, in the pancreas is commonly followed up, we highly recommend advancing to dynamic CT, MRI, EUS, and/or PET because of the possibility of the early stage of a solid neoplasm like ACC.
