BACKGROUND:Acinar cell carcinoma (ACC) is a rare malignancy of the pancreas arising from acinar cells.Unlike ductal adenocarcinoma,this tumor rarely presents with pancreatitis.METHODS:We present a case of ACC associat...BACKGROUND:Acinar cell carcinoma (ACC) is a rare malignancy of the pancreas arising from acinar cells.Unlike ductal adenocarcinoma,this tumor rarely presents with pancreatitis.METHODS:We present a case of ACC associated with chronic calcifying pancreatitis,and a review of the literature focusing on diagnosis and management.RESULTS:A 43-year-old man was proposed for Wirsungojejunal derivation for chronic pancreatitis.Histopathological examination of the tissue extracted revealed an ACC.Duodenopancreatectomy was performed.Six months postoperatively,the patient developed hepatic metastasis and was treated with gemcitabine as palliative chemotherapy.CONCLUSIONS:The clinical presentation of ACC of the pancreas is not specific and the tumor can be underdiagnosed when associated with chronic pancreatitis.Data regarding course,treatment,and prognosis of this tumor are generally lacking.展开更多
BACKGROUND: An increasing number of elderly patients have been considered for major surgical procedures, such as pancreaticoduodenectomy. The decision to recommend this operation for localized pancreatic cancer or oth...BACKGROUND: An increasing number of elderly patients have been considered for major surgical procedures, such as pancreaticoduodenectomy. The decision to recommend this operation for localized pancreatic cancer or other periampullary process in a very elderly patient is complicated by the frailty of the patient and the poor prognosis of the disease. Moreover, increased surgical experience associated with better patient selection may reduce the mortality rate, even in very elderly patients (over 80 years of age), after pancreaticoduodenectomy. METHODS: An 84-year-old woman underwent pancreatico- duodenectomy for ampullary adenocarcinoma. The tumor was classified pT3N0M0. RESULT: A good postoperative outcome was obtained. The patient is still alive, 18 months after operation. CONCLUSIONS: Radical resection of periampullary tumors is safe in selected patients of advanced age, with morbidity and mortality rates approaching those observed in younger patients. Age alone should not be a contraindication for pancreatic resection.展开更多
文摘BACKGROUND:Acinar cell carcinoma (ACC) is a rare malignancy of the pancreas arising from acinar cells.Unlike ductal adenocarcinoma,this tumor rarely presents with pancreatitis.METHODS:We present a case of ACC associated with chronic calcifying pancreatitis,and a review of the literature focusing on diagnosis and management.RESULTS:A 43-year-old man was proposed for Wirsungojejunal derivation for chronic pancreatitis.Histopathological examination of the tissue extracted revealed an ACC.Duodenopancreatectomy was performed.Six months postoperatively,the patient developed hepatic metastasis and was treated with gemcitabine as palliative chemotherapy.CONCLUSIONS:The clinical presentation of ACC of the pancreas is not specific and the tumor can be underdiagnosed when associated with chronic pancreatitis.Data regarding course,treatment,and prognosis of this tumor are generally lacking.
文摘BACKGROUND: An increasing number of elderly patients have been considered for major surgical procedures, such as pancreaticoduodenectomy. The decision to recommend this operation for localized pancreatic cancer or other periampullary process in a very elderly patient is complicated by the frailty of the patient and the poor prognosis of the disease. Moreover, increased surgical experience associated with better patient selection may reduce the mortality rate, even in very elderly patients (over 80 years of age), after pancreaticoduodenectomy. METHODS: An 84-year-old woman underwent pancreatico- duodenectomy for ampullary adenocarcinoma. The tumor was classified pT3N0M0. RESULT: A good postoperative outcome was obtained. The patient is still alive, 18 months after operation. CONCLUSIONS: Radical resection of periampullary tumors is safe in selected patients of advanced age, with morbidity and mortality rates approaching those observed in younger patients. Age alone should not be a contraindication for pancreatic resection.