Work

A rare cystic and papillary variant of acinar cell carcinoma with liver metastasis and molecular analysis

Year: 2025

Type: article

Abstract: Acinar cell carcinoma (ACC) is a pancreatic neoplasm with histologic variants that pose significant diagnostic challenges. We report a 75-year-old man with a previously unreported cystic and papillary ACC metastatic to the liver. Histologically, the tumor exhibited cystic and papillary proliferations of epithelial cells with eosinophilic cytoplasm, prominent nucleoli, and frequent mitoses. Immunohistochemical analysis showed positivity for trypsin and BCL-10, confirming ACC. The cyst lining displayed both acinar and ductal features, suggesting origin from acinar cystic transformation with acinar-to-ductal metaplasia rather than a true intraductal neoplasm. Molecular studies identified NRAS, CTNNB1, and SMAD4 mutations. Despite reports of indolent behavior in similar variants, our patient developed peritoneal metastasis and died 2 years after surgery and chemotherapy, highlighting the potential for aggressive clinical behavior and the importance of distinguishing these tumors from benign cystic pancreatic neoplasms.

Source: Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin

DOI: 10.1007/s00428-025-04315-y

Authors: Meredith K. Herman, Eric Chang, Jiaqi Shi

Institutions: University of Michigan, Michigan Medicine

Language: English

Topic: Pancreatic and Hepatic Oncology Research

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,790