A case of pancreatic acinar cell carcinoma with temporally changing morphology and internal characteristics effectively treated by neoadjuvant chemotherapy

Abstract

A woman in her 60s with jaundice and cholangitis was admitted to our hospital to undergo examination of a pancreatic tumor. A contrast-enhanced computed tomography (CT) scan for acute pancreatitis 5 months ago showed a 20mm mass with a cystic component. However, on a CT scan preformed at admission, the tumor with its cystic component had enlarged to 40mm with enhanced part. We performed endoscopic retrograde cholangiopancreatography (ERCP) for bile duct drainage and the tumor was diagnosed as an acinar cell carcinoma (ACC) by transpapillary biopsy. Radical surgical resection was performed after neo-adjuvant chemotherapy (modified FOLFIRINOX). This case study highlights one important characteristic of ACC, which is that it may develop morphological changes within a short period of time.