Acinar cell carcinoma of the pancreas: is the absence of neuroendocrine component related to a more malignant behavior?
OBJECTIVE
Acinar cell carcinomas are uncommon malignant tumors of the pancreas, accounting for 1-2% of all the cases of exocrine pancreatic tumor. Some authors have estimated acinar cell tumors to be as aggressive as ductal adenocarcinoma of the pancreas whereas other series showed acinar cell tumors to have a favorable clinical outcome. This discrepancy in prognosis may be related to the cellular components of the tumor.


METHODS
With the aim to evaluate the possible relationship between the presence of neuroendocrine differentiation and behavior of these tumors, the authors reviewed all patients presenting acinar cell carcinoma of the pancreas in the last 5 years with emphasis in the immunohistochemical evaluation.


RESULTS
Four patients presented neuroendocrine differentiation on immunohistochemical evaluation and had a more benign outcome. Two patients without neuroendocrine component had a disseminated disease at presentation. This data suggests that this tumor is less aggressive than ductal adenocarcinoma and even with nodal involvement, long-term survival after complete resection can be achieved.


CONCLUSIONS
It is possible that the absence of neuroendocrine component may be related to a less favorable outcome and adjuvant therapy may be necessary. Due to the rarity of this pancreatic tumor, this relationship remains to be confirmed with a multicentric study including a larger number of patients.
Machado
Marcel Cerqueira C
MC
Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
Machado
Marcel Autran C
MA
Perini
Marcos V
MV
Herman
Paulo
P
Jukemura
José
J
Leite
Kátia R
KR
Bacchella
Telesforo
T
D000328:Adult; D018267:Carcinoma, Acinar Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009490:Neurosecretory Systems; D010190:Pancreatic Neoplasms / Q000473:pathology*