Metachronous metastatic pancreatoblastoma to the liver in an elderly patient misdiagnosed as pancreatic acinar cell carcinoma

BMJ Case Rep. 2022 Dec 30;15(12):e252910. doi: 10.1136/bcr-2022-252910.

Abstract

A woman in her 80s was evaluated for a liver mass. She had a history of what was reported as pancreatic acinar cell carcinoma resected with a pancreatoduodenectomy 10 years prior at another institution. Liver biopsy showed metastatic pancreatoblastoma (PB) and staging imaging showed no evidence of additional metastatic disease. She underwent laparoscopic non-anatomic partial hepatectomy and recovered uneventfully. The liver pathology was reviewed along with slides from her initial pancreatoduodenectomy, and both were noted to be consistent with PB. PB contains similar histological characteristics to pancreatic acinar cell carcinoma. Distinguishing between the two diagnoses is critical for accurately defining the prevalence, clinical course and prognosis associated with PB.

Keywords: Gastrointestinal surgery; Pancreas and biliary tract; Pancreatic cancer; Pathology; Surgical oncology.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma, Acinar Cell* / pathology
  • Diagnostic Errors
  • Female
  • Humans
  • Liver / pathology
  • Pancreatic Neoplasms* / pathology

Supplementary concepts

  • Pancreatoblastoma