Pancreatic acinar cell carcinoma presenting with panniculitis, successfully treated with FOLFIRINOX: A case report

Yoshihiro,Tomoyasu; Nio,Kenta; Tsuchihashi,Kenji; Ariyama,Hiroshi; Kohashi,Kenichi; Tsuruta,Nobuhiro; Hanamura,Fumiyasu; Inadomi,Kyoko; Ito,Mamoru; Sagara,Kosuke; Okumura,Yuta; Nakano,Michitaka; Arita,Shuji; Kusaba,Hitoshi; Oda,Yoshinao; Akashi,Koichi; Baba,Eishi

doi:10.3892/mco.2017.1240

June-2017 Volume 6 Issue 6

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June-2017 Volume 6 Issue 6

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Case Report Open Access

Pancreatic acinar cell carcinoma presenting with panniculitis, successfully treated with FOLFIRINOX: A case report

Authors:
- Tomoyasu Yoshihiro
- Kenta Nio
- Kenji Tsuchihashi
- Hiroshi Ariyama
- Kenichi Kohashi
- Nobuhiro Tsuruta
- Fumiyasu Hanamura
- Kyoko Inadomi
- Mamoru Ito
- Kosuke Sagara
- Yuta Okumura
- Michitaka Nakano
- Shuji Arita
- Hitoshi Kusaba
- Yoshinao Oda
- Koichi Akashi
- Eishi Baba
View Affiliations / Copyright

Affiliations: Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812‑8582, Japan, Department of Anatomical Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan, Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan

Copyright: © Yoshihiro et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 866-870
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Published online on: May 5, 2017

https://doi.org/10.3892/mco.2017.1240
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Abstract

Pancreatic acinar cell carcinoma (PACC) is a rare tumor of the exocrine pancreas, representing only 1% of all pancreatic malignancies. A 50‑year‑old man presented with edema of the thumb joints bilaterally, followed by an appearance of masses in the bilateral lower extremities and fever (38˚C). The masses were diagnosed as panniculitis by skin biopsy, and multiple intraperitoneal masses were incidentally detected on pelvic magnetic resonance imaging performed to investigate the leg abnormalities. The patient was referred to the Kyushu University Hospital for further investigation, and fluorodeoxyglucose‑positron emission tomography/computed tomography (CT) revealed high‑uptake tumors in the pancreatic tail, in the periphery of the liver, and in the pelvis. Laboratory examinations revealed high serum concentrations of pancreatic exocrine enzymes, such as lipase, trypsin, elastase 1 and pancreatic phospholipase A2. Histological examination of a bioptic specimen obtained from a hepatic lesion revealed proliferation of atypical cells arranged in a tubular or glandular pattern. Immunohistochemical staining revealed that the atypical cells were positive for cytokeratin (CK)7, CK19 and lipase, but negative for CK20 and thyroid transcription factor‑1, leading to a final diagnosis of acinar cell carcinoma of the pancreatic tail (T4bN0M1, stage IV according to the 7th edition of the TNM Classification of Malignant Tumors). Combined chemotherapy with oxaliplatin, irinotecan and fluorouracil (FOLFIRINOX) was administered and fever was soon alleviated. The serum levels of lipase also declined and panniculitis completely resolved. As of the start of the 8th course of chemotherapy, the levels of the pancreatic exocrine enzymes were within normal ranges and CT revealed partial response. Therefore, the severe lipase hypersecretion syndrome was well controlled by the FOLFIRINOX regimen and shrinkage of the mass was also achieved. Thus, the FOLFIRINOX regimen may represent an effective treatment option for advanced PACC.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Pancreatic acinar cell carcinoma presenting with panniculitis, successfully treated with FOLFIRINOX: A case report

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