Acinar Cystic Transformation of the Pancreas: A Diagnostic Problem

Acinar cystic transformation (ACT) or acinar cell cystadenoma is a rare benign tumor of the pancreas. Their clinical presentation is nonspecific, thus hampering their detection and frequently leading to misdiagnosis. In this report, we present a case of ACT of the pancreas in a 54-year-old man that was vague abdominal symptoms. A magnetic resonance imaging was shown a well-defined cystic mass located in the head of the pancreas, measuring 57×47×23 mm. Our patient was treated by pancreaticoduodenectomy. In the macroscopic examination of the mass, a multicystic lesion was found in cream-colored pancreatic tissue. Histological and immunohistochemical studies examination revealed a cystic mass containing multiple cysts at varying sizes, lined by epithelial cells without atypia and positive staining of CK7, CK8/18, and CK19. A high index of clinical suspicion is required to diagnose this tumor. The surgical approach is to ensure accurate diagnosis and to avoid complications.