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Case Reports in Hepatology
Volume 2017, Article ID 1847428, 7 pages
https://doi.org/10.1155/2017/1847428
Case Report

Liver Metastases in Pancreatic Acinar Cell Carcinoma Treated with Selective Internal Radiation Therapy with Y-90 Resin Microspheres

1Interventional Radiology Unit, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil
2Pathology Department, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil
3Nuclear Medicine Unit, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil
4Oncology Department, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil
5Cardiology Department, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil
6General and Oncological Surgery, Hospital Israelita Albert Einstein, Av. Albert Einstein 627/701, Morumbi, 05652-900 São Paulo, SP, Brazil

Correspondence should be addressed to Joaquim Maurício Motta Leal Filho; rb.moc.oohay@fuamatoj

Received 24 April 2017; Accepted 10 September 2017; Published 11 October 2017

Academic Editor: Melanie Deutsch

Copyright © 2017 Felipe Nasser et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Pancreatic acinar cell carcinoma (PACC) is a rare tumor. Surgical resection is the treatment of choice when feasible, but there are no clear recommendations for patients with advanced disease. Liver-directed therapy with Y-90 selective internal radiation therapy (SIRT) has been used to treat hepatic metastases from pancreatic tumors. We describe a case of PACC liver metastases treated with SIRT. Case Report. 59-year-old man was admitted with an infiltrative, solid lesion in pancreatic tail diagnosed as PACC. Lymph nodes in the hepatic hilum were enlarged, and many metastatic liver nodules were observed. After partial pancreatectomy, the left and right lobes of the liver were separately treated with Y-90 resin microspheres. Follow-up imaging revealed that all hepatic nodules shrank by at least 50%, and 3 nodules disappeared completely. Lipase concentration was 8407 U/L at baseline, rose to 12,705 U/L after pancreatectomy, and declined to 344 U/L after SIRT. Multiple rounds of chemotherapy in the subsequent year shrank the hepatic tumors further; disease then progressed, but a third line of chemotherapy shrank the tumors again, 16 months after SIRT treatment. Conclusion. SIRT had a positive effect on liver metastases from PACC. In conjunction with systemic therapy, SIRT can achieve sustained disease control.