Spontaneous Rupture of Pancreatic Acinar Cell Carcinoma: Report of a Case

Author:

Yamazoe Sadaaki1,Amano Ryosuke1,Kimura Kenjiro1,Ohira Go1,Nishio Kohei1,Miura Kotaro1,Shibutani Masatsune1,Sakurai Katsunobu1,Nagahara Hisashi1,Toyokawa Takahiro1,Kubo Naoshi1,Tanaka Hiroaki1,Muguruma Kazuya1,Ohtani Hiroshi1,Yashiro Masakazu1,Maeda Kiyoshi1,Ohira Masasichi1,Hirakawa Kosei1

Affiliation:

1. Department of Surgical Oncology (First Department of Surgery), Osaka City University Graduate School of Medicine, Osaka, Japan

Abstract

Introduction Pancreatic acinar cell carcinoma (ACC) is a relatively rare neoplasm. Furthermore, tumor rupture is extremely rare. Only 1 case of ruptured pancreatic ACC has been reported, and the long-term outcome of the case is unknown. Here, we present a case of spontaneously ruptured ACC with long-term survival after successful resection. Case Presentation A 67-year-old man was brought to our hospital by ambulance, presenting with progressive left abdominal pain. Laboratory data showed an increased inflammatory response, and contrast-enhanced computed tomography showed a mass in the pancreas tail with nonuniform enhancement in the early phase. Fluid collection was detected around the spleen to the left kidney. Spontaneous rupture of a pancreatic tumor was strongly suspected. After improvement of his general condition, the patient underwent resection of the pancreas and adjacent organs. The resected tumor was surrounded by organs and adipose tissue, so obvious exposure was not observed in the surgical margins. Pathologically, neither exposure of tumor cells at the surgical margins nor lymph node involvement was detected. The patient has survived 80 months since initial diagnosis without any evidence of recurrence. Conclusion Although ruptured pancreatic ACC has the potential for dissemination, surgical resection including adjacent organs remains an option for curative treatment.

Publisher

International College of Surgeons

Subject

Surgery

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