Abstract
Acinar cell cystadenoma (ACA) of the pancreas has been newly recognized as an entity by the World Health Organization (WHO) definition (2010), and its pathogenesis has not been known adequately because of the rarity. Here, we report a case of a 22-year-old female who had been followed up for a cystic lesion at the tail of the pancreas pointed out by a screening computed tomography (CT) scan 7 years ago. The tumor grew in size from 3.3 to 5.1 cm in diameter for 6 years (0.3 cm per year). Particularly, it rapidly grew up to 6.3 cm in the latest 3 months in concurrence with the emergence of epigastralgia. A contrasted CT scan revealed the irregularly formed, multilocular cystic tumor having thin septum and calcification. The intratumoral magnetic resonance imaging intensity in the T1 and T2 weighted images were low and high, respectively. No communications between the tumor and the main pancreatic duct (MPD) were found, but the tumor displaced the MPD. She underwent surgical resection because the tumor was growing, turned symptomatic, and it seemed difficult to be diagnosed correctly until totally biopsied. Spleen-preserved distal pancreatectomy was performed. It was pathologically diagnosed as ACA; the cyst was lined by cells with normal acinar differentiation; cuboidal cells with round, basally oriented nuclei and eosinophilic granules in its apical cytoplasm. The abdominal pain has disappeared, and no recurrences have been found during a 5-year follow-up. Clinicians are recommended to consider an ACA as one of differential diagnoses of cystic tumors of the pancreas to provide appropriate diagnostics and therapeutics.
Highlights
Acinar cell neoplasms of the pancreas is a rare disease representing only 2 % of pancreatic neoplasms [1]
acinar cell cystadenoma (ACA) are benign cystic lesions lined by cells with acinar differentiation without atypical changes [2]
Here, we reported a surgical case of an ACA of the pancreas, which showed interesting radiologic features and clinical courses
Summary
Acinar cell neoplasms of the pancreas is a rare disease representing only 2 % of pancreatic neoplasms [1]. ACAs are benign cystic lesions lined by cells with acinar differentiation without atypical changes [2]. Tanaka et al Surgical Case Reports (2016) 2:39 she was 15 years old (Fig. 1). After she has transferred to our hospital, a routine follow-up has been provided to put the lesion under surveillance. Small branches of the pancreatic duct around the tumor were detected (Fig. 4). A cystic lesion lined by cells with acinar differentiation was pointed out. Positive staining of α1-antichymotrypsin, α1-antitrypsin (pancreatic enzyme marker), AE1/AE3, CAM-5.2 and CK7 (epithelial marker), and MIB-1 index was
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