Endoscopic Ultrasound–Guided Chemoablation of an Acinar Cell Carcinoma as a Suppressive Strategy for Unresectable Disease

Acinar cell carcinoma is a relatively rare pancreatic neoplasm, typically treated with surgical resection and adjuvant chemotherapy; however, definitive treatment protocols are not well established. We describe endoscopic ultrasound-guided chemoablation with fine needle injection of paclitaxel/gemcitabine in conjunction with chemotherapy in a 78-year-old man with a 3.0 × 2.7-cm acinar cell carcinoma who was not a surgical candidate. At 12 months, the mass had reduced in size to 0.9 × 0.9 cm, followed by steady growth to 6 × 4.5 cm at 24 months when the patient died secondary to unrelated causes.