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Case Reports Hepatol. 2017;2017:1847428. doi: 10.1155/2017/1847428. Epub 2017 Oct 11.

Liver Metastases in Pancreatic Acinar Cell Carcinoma Treated with Selective Internal Radiation Therapy with Y-90 Resin Microspheres.

Author information

1
Interventional Radiology Unit, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil.
2
Pathology Department, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil.
3
Nuclear Medicine Unit, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil.
4
Oncology Department, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil.
5
Cardiology Department, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil.
6
General and Oncological Surgery, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil.

Abstract

Background:

Pancreatic acinar cell carcinoma (PACC) is a rare tumor. Surgical resection is the treatment of choice when feasible, but there are no clear recommendations for patients with advanced disease. Liver-directed therapy with Y-90 selective internal radiation therapy (SIRT) has been used to treat hepatic metastases from pancreatic tumors. We describe a case of PACC liver metastases treated with SIRT.

Case Report:

59-year-old man was admitted with an infiltrative, solid lesion in pancreatic tail diagnosed as PACC. Lymph nodes in the hepatic hilum were enlarged, and many metastatic liver nodules were observed. After partial pancreatectomy, the left and right lobes of the liver were separately treated with Y-90 resin microspheres. Follow-up imaging revealed that all hepatic nodules shrank by at least 50%, and 3 nodules disappeared completely. Lipase concentration was 8407 U/L at baseline, rose to 12,705 U/L after pancreatectomy, and declined to 344 U/L after SIRT. Multiple rounds of chemotherapy in the subsequent year shrank the hepatic tumors further; disease then progressed, but a third line of chemotherapy shrank the tumors again, 16 months after SIRT treatment.

Conclusion:

SIRT had a positive effect on liver metastases from PACC. In conjunction with systemic therapy, SIRT can achieve sustained disease control.

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