title: Long-term survival in a patient with acinar cell carcinoma of pancreas. A case report and review of literature.
abstract: BACKGROUND
  Acinar cell carcinoma of the pancreas is a rare malignancy that may have acinar and endocrine differentiation. Clinical practice guidelines exist for pancreatic ductal adenocarcinoma. However, treatment protocols for acinar cell carcinoma of the pancreas have not been standardized.
  
  
  METHODS
  We describe a case of a 44-year-old woman presenting with low grade fever and mid-abdominal tenderness secondary to a pancreatic mass with acinar and endocrine differentiation metastatic to the liver. The patient received multiple lines of conventional and investigational chemotherapy regimens. This included cycles of gemcitabine, irinotecan, oxaliplatin, docetaxel, capecitabine, octreotide, leucovorin, 5-fluorouracil, cisplatin, protein kinase C inhibitor, tyrosine kinase inhibitor, and a novel taxane. The patient developed Clostridium difficile colitis and septic shock resulting in death 37 months after the diagnosis of acinar cell carcinoma of the pancreas.
  
  
  CONCLUSIONS
  This is a case of acinar cell carcinoma of the pancreas with an endocrine component, treated with multiple chemotherapeutic agents, in which the patient survived 37 months after diagnosis.
authors.affiliation: Yale Cancer Center, Yale University School of Medicine, New Haven, CT 06520, USA.
authors.forename: Monique
authors.initials: M
authors.lastname: Antoine
authors.forename: Marina
authors.initials: M
authors.lastname: Khitrik-Palchuk
authors.forename: Muhammad Wasif
authors.initials: MW
authors.lastname: Saif
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018267:Carcinoma, Acinar Cell / Q000188:drug therapy*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D016019:Survival Analysis; D016896:Treatment Outcome