Robot-assisted combined pancreatectomy/hepatectomy for metastatic pancreatic acinar cell carcinoma: case report and review of the literature

Acinar cell carcinoma (ACC) of the pancreas is a rare neoplasm with less aggressive behavior than ductal carcinoma. As a result, surgical resection for metastatic ACC is a therapeutic option which can result in long-term survival. There is a paucity of data describing institutional approaches to the...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2020-10, Vol.13 (5), p.973-980
Main Authors: Villano, Anthony Michael, Barrak, Dany, Jain, Anish, Meslar, Erin, Radkani, Pejman, Chalhoub, Walid, Haddad, Nadim, Winslow, Emily, Fishbein, Thomas, Hawksworth, Jason
Format: Article
Language:English
Subjects:
Abdominal Surgery
Case Report
Colorectal Surgery
Gastroenterology
Hepatology
Medicine
Medicine & Public Health
Surgical Oncology
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Summary:Acinar cell carcinoma (ACC) of the pancreas is a rare neoplasm with less aggressive behavior than ductal carcinoma. As a result, surgical resection for metastatic ACC is a therapeutic option which can result in long-term survival. There is a paucity of data describing institutional approaches to these challenging patients, and therefore, we herein describe our institution’s approach to a patient with a distal pancreatic ACC and isolated liver metastasis. The patient underwent neoadjuvant chemotherapy (FOLFIRINOX), followed by a robot-assisted distal pancreatectomy/splenectomy and non-anatomic segment 6 resection. He was discharged to home post-operative day 2. Final pathology revealed complete tumor response of the liver metastasis and a margin negative resection of the primary tumor. He remains disease free and without complications at 3 months. We highlight that combined modality therapy for metastatic ACC can yield long-term survival in selected patients. Similarly, the robotic platform enables performance of complex multivisceral resections with rapid recovery. Future research investigating precision medicine for metastatic ACC is warranted given widely variable tumor biology in this disease.
ISSN:1865-7257
1865-7265
DOI:10.1007/s12328-020-01146-z