Title |
Metastatic mixed acinar-endocrine carcinoma of the pancreas treated with a multidisciplinary approach: a case report
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Published in |
Surgical Case Reports, March 2017
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DOI | 10.1186/s40792-017-0326-y |
Pubmed ID | |
Authors |
Takeo Hara, Yoshiyuki Fujiwara, Hidenori Takahashi, Keijiro Sugimura, Jeong-Ho Moon, Takeshi Omori, Norikatsu Miyoshi, Akira Tomokuni, Hirofumi Akita, Shogo Kobayashi, Masayoshi Yasui, Hiroshi Miyata, Masayuki Ohue, Masato Sakon, Yasuhiko Tomita, Masahiko Yano |
Abstract |
Pancreatic neoplasms are usually characterized by ductal, acinar, or endocrine differentiation. Mixed exocrine and endocrine pancreatic tumours are extremely rare. Here, we report a case of pancreatic mixed acinar-endocrine carcinoma (MAEC) with multiple synchronous liver metastases that were treated with surgery and transcatheter arterial chemoembolization (TACE) that later recurred in the stomach. A 45-year-old female with severe anaemia was referred to our hospital. Computed tomography (CT) demonstrated a hypervascular tumour, 17 cm in diameter, that was in the tail of the pancreas. In addition, there were multiple hypervascular tumours in the liver. She underwent a distal pancreatectomy with splenectomy after the liver metastases were treated with TACE. Pathology confirmed that the pancreatic tumour was MAEC. After 4.5 years, a follow-up CT showed a hypervascular tumour at the upper part of the stomach. Gastric endoscopy showed a big tumefactive lesion with surface irregularities, gastric erosion, and multiple dilated vessels in the fornix and greater curvature of the stomach. She underwent a proximal gastrectomy and survived 7 years and 2 months after the start of the treatment. This is the first report of a metastatic stomach tumour from pancreatic MAEC, which was successfully treated with a multidisciplinary approach. Additionally, we review the literature and discuss the treatment of MAEC. |
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