Pancreatic acinar cell carcinoma with predominant extension into the main pancreatic duct: A case report

A 34-year-old male was referred to our hospital for a possible pancreatic mass detected by computed tomography (CT) that was performed to find the cause of acute pancreatitis. Multiple imaging tests, including contrast-enhanced CT scan, magnetic resonance imaging, contrast-enhanced endoscopic ultrasonography, and endoscopic retrograde pancreatography, revealed a solid mass occupying the head of the main pancreatic duct (MDP), and pancreaticoduodenectomy was performed. In the resected specimen, the tumor showed expansive growth from the pancreatic parenchyma to the MDP and formed a tumor plug. Histopathological findings together with immunostaining findings led to the diagnosis of pancreatic acinar cell carcinoma (PACC). The patient was alive and recurrence-free for 11 years after surgery. Extension into the MDP is more common in PACC than in conventional pancreatic ductal adenocarcinoma. PACC patients with MDP extension may have less aggressive clinicopathologic characteristics, and a relatively good prognosis can be expected.