title: Acinar cell carcinoma of the pancreas with and without endocrine differentiation.
abstract: BACKGROUND
  Acinar cell carcinoma (ACC) is a rare pancreatic neoplasm, representing 1% of exocrine tumours and containing a variable endocrine component. Three recent cases of ACC are reported.
  
  
  METHODS
  A 72-year-old man with painless obstructive jaundice had a 5-cm mass in the head of pancreas resected by Whipple's operation; histopathological examination showed a typical ACC. A 33-year-old man with weight loss and abnormal liver function had a dilated biliary tree but no mass on imaging. Pylorus-preserving pancreatoduodenectomy was performed, and histology showed a mixed acinar-neuro-endocrine tumour. A 56-year-old man with weight loss and a palpable mass had a 15-cm mass in the distal body of pancreas, which was resected en bloc with the spleen and adherent stomach; it was a cystic ACC.
  
  
  RESULTS
  Two patients are alive and free of disease at 30 months and 15 months, while the third patient with locally advanced disease died of myocardial infarction at 9 weeks.
  
  
  CONCLUSIONS
  Acinar structures are the hallmark of this neoplasm, which carries a better survival rate than ductal cancer. Surgical excision prolongs survival and offers the best chance of cure.
authors.affiliation: Department of Surgery, Hammersmith Hospital, London, UK.
authors.forename: I T
authors.initials: IT
authors.lastname: Virlos
authors.forename: I M
authors.initials: IM
authors.lastname: Papazachariou
authors.forename: R C N
authors.initials: RC
authors.lastname: Wiliamson