|Pancreatic Pathology Online
Pathology of Pancreatic Carcinoma with Mixed Differentiation
Mixed acinar-endocrine carcinoma (MAEC) is a rare mixed tumor of the pancreas defined by both acinar and endocrine cell differentiation.
Carcinomas with mixed exocrine and endocrine tissue are rare.
The pancreatic tumour may exhibit ductal, acinar, or endocrine features, depending on the point at which neoplastic transformation occurs along the pathway of proliferation and differentiation of these cells.
Among these, the rare "mixed" tumors reported are:
1. Ductal - islet cell carcinoma
2. Acinar - islet cell carcinoma
3. Ductal - acinar - islet cell carcinoma.
Ductal, acinar and islet cell components of pancreas show a common embryogenesis from the foregut endoderm.
If the transformation occurs at an early stage, more than one line of differentiation may be expressed.
These tumours have the same prognosis as common ductal pancreatic carcinomas.
Mixed acinar-endocrine carcinoma have potentially more aggressive clinical course and different therapeutic implications and are an important consideration in the differential diagnosis of pancreatic neoplasms.
Mixed acinar-endocrine carcinoma of the pancreas should be considered in elderly male patients with large pancreatic mass and may warrant aggressive surgical resection and chemotherapy.
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