Genetic basis of a common tumor origin in the development of pancreatic mixed acinar‑neuroendocrine‑ductal carcinoma: A case report

Takano,Atsushi; Hirotsu,Yosuke; Amemiya,Kenji; Nakagomi,Hiroshi; Oishi,Naoki; Oyama,Toshio; Mochizuki,Hitoshi; Omata,Masao

doi:10.3892/ol.2017.6786

Genetic basis of a common tumor origin in the development of pancreatic mixed acinar‑neuroendocrine‑ductal carcinoma: A case report

Authors:
- Atsushi Takano
- Yosuke Hirotsu
- Kenji Amemiya
- Hiroshi Nakagomi
- Naoki Oishi
- Toshio Oyama
- Hitoshi Mochizuki
- Masao Omata
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Affiliations: Department of Surgery, Yamanashi Central Hospital, Yamanashi 400‑8506, Japan, Genome Analysis Center, Yamanashi Central Hospital, Yamanashi 400‑8506, Japan, Department of Pathology, University of Yamanashi, Yamanashi 409‑3898; 5The University of Tokyo, Tokyo 113‑8655, Japan, Department of Pathology, Yamanashi Central Hospital, Yamanashi 400‑8506, Japan
Published online on: August 22, 2017 https://doi.org/10.3892/ol.2017.6786
Pages: 4428-4432
Copyright: © Takano et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Pancreatic cancer is classified as ductal, acinar, neuroendocrine carcinoma or pancreatoblastoma. Ductal and acinar cells derive from exocrine glands and neuroendocrine cells from endocrine glands; however, mixed acinar‑neuroendocrine‑ductal carcinoma has different histological carcinomas coexisting within a nodule. The mixed pancreatic carcinoma forms from different developmental origins and therefore requires investigation. The current case report presents a 50‑year‑old male who had a tumor within the body of the pancreas. Pathological examination clarified the tumor as a mixed acinar-neuroendocrine‑ductal carcinoma. The ductal and acinar/neuroendocrine tumor components were isolated using laser‑capture microdissection, and next‑generation sequencing analysis was performed. Consequently, TP53 frameshift (p.N210fs) and KRAS missense (p.G12R) mutations were identified in both ductal and acinar/neuroendocrine tumors. These results suggested a pancreatic mixed acinar‑neuroendocrine‑ductal carcinoma was derived from a founder tumor clone, and supports the notion that a founder tumor clone may differentiate and transform into a diverse histological type and form a pancreatic mixed carcinoma.

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