A case of pancreatic acinar cell carcinoma treated by neoadjuvant chemotherapy and subsequent resection

We report a case of pancreatic acinar cell carcinoma, treated by neoadjuvant chemotherapy and subsequent curative resection. A 55-year-old woman, presenting with back pain and weight loss, was given a diagnosis of stage IVa pancreatic cancer. Because the tumor size was large measuring 6.8cm in diameter, the patient underwent neoadjuvant chemotherapy using a combination of gemcitabine and S-1 (GS), attempting to reduce the tumor volume as well as to observe possible progression of micrometastasis of the liver or peritoneum. After 2 months of chemotherapy, the tumor volume decreased to 4.8cm in diameter, with no findings of distant metastasis. Thereafter, the patient underwent curative distal pancreatectomy with D2 lymphadenectomy. The pathological findings of the resected specimen demonstrated stage III moderately differentiated acinar cell carcinoma. Subsequently, she had completed adjuvant GS therapy using the same regimen 6 months prior to surgery without any adverse events. However, she had a local recurrence 3 months later, and required re-administration of GS therapy.