A CASE OF ALPHA-FETOPROTEIN-POSITIVE ADVANCED ACINAR CELL CARCINOMA OF THE PANCREAS MERKEDLY IMPROVED BY INTRA-ARTERIAL INFUSION CHEMOTHERAPY

We report a case of alpha-fetoprotein-positive advanced acinar cell carcinoma of the pancreas which was highly sensitive to the intra-arterial infusion of chemotherapeutics. A 41-year-old woman was admitted to the hospital because of jaundice. Preoperative computed tomography revealed a mass extending from the head to body of the pancreas. Angiography via gastroduodenal artery and dorsal pancreatic artery showed hypervascularity at the lesion. Serum alphafetoprotin level at the preoperative stage was extremely high, 23, 003 ng/ml. On laparotomy, severe invasion of the malighant tissue was found to the adjoining tissue of the pancreas. The lesion was judged to be unresectable. Therefore, gastrojejunostomy, ligation, of the right gastric artery and biopsy were performed. The histopathological finding indicated acinar cell carcinoma of the pancreas with proliferation of malignant neoplastic cells, which were immunohistochemically positive with antibodies against AFP. Intra-arterial superselective infusion of chemotherapeutic agents (EPIR 60 mg, MMC 20 mg, 5-FU 500 mg) was done twice after the operation. The size of the tumor was and the serum alpha-fetoprotein level markedly decreased. Quality of life of the patient improved after these treatments.