title: Mixed acinar-neuroendocrine carcinoma of the pancreas: a case report and a review.
abstract: A 62-year-old woman presented with abdominal discomfort. Imaging studies showed a tumor in the pancreatic tail. At contrast-enhanced CT and macroscopy, the tumor showed cystic, solid and hemorrhagic areas. Histologically, the tumor was well-circumscribed and entirely encapsulated. Some of the tumor cells in the cystic areas were reminiscent of acinar cells, and the majority was arranged in a solid growth pattern. Immunohistochemistry revealed >30% positivity for chymotrypsin, chromogranin A, synaptophysin, and CD56. The diagnosis of a mixed acinar-neuroendocrine carcinoma (MAEC) was made. Review of the English-language literature revealed 44 previously published cases of resected MAECs. We found that, compared to pure acinar cell carcinoma, patients with MAEC have a slightly higher age and are less frequently males, as the male / female ratio was almost equal. The histogenesis of MAEC is still controversial. Due to the small number of cases it is at present not possible to define an evidence-based optimal treatment strategy for these patients.
authors.affiliation: Department of Pathology, Odense University Hospital, Odense, Denmark.
authors.forename: Mark
authors.initials: M
authors.lastname: Jakobsen
authors.affiliation: Department of Pathology, Technical University of Munich, Munich, Germany.
authors.forename: Günter
authors.initials: G
authors.lastname: Klöppel
authors.affiliation: Department of Pathology, Odense University Hospital, Odense, Denmark. Sonke.Detlefsen@rsyd.dk.
authors.forename: Sönke
authors.initials: S
authors.lastname: Detlefsen
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D018267:Carcinoma, Acinar Cell / Q000473:pathology*; D018278:Carcinoma, Neuroendocrine / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor