Mucinous Cystic Neoplasms of the Pancreas with Overt and Latent Malignancy (Cystadenocarcinoma and Cystadenoma): A Clinicopathologic Study of 41 Cases

Compagno, John; Oertel, James E.

doi:10.1093/ajcp/69.6.573

Cited by 653 publications

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“…1,2 Mucinous cystic neoplasms develop almost exclusively in middle-aged and elderly women, and are associated with a significant risk of malignant change from adenoma to carcinoma. 8 Therefore, it is generally accepted that mucinous cystic neoplasms need to be resected completely. 9 Patients with non-invasive mucinous cystic neoplasms have a fair prognosis; however, those with invasive mucinous cystic neoplasms have a poor prognosis, with a 5-year survival rate of 16-30%.…”

mentioning

confidence: 99%

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Kuboki

Shiratori²,

Hatori³

et al. 2010

Modern Pathology

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The molecular pathobiology of pancreatic cystic neoplasms is poorly understood. The aim of this study was to know the involvement of epidermal growth factor receptor (EGFR) and its downstream targets in the serous cystic neoplasms and the mucinous cystic neoplasms of the pancreas. In a total of 72 pancreatic cystic neoplasms, including 39 serous cystic neoplasms and 33 mucinous cystic neoplasms, we examined the expression of native and phosphorylated EGFR, mitogen-activated protein kinase (MAPK), and AKT by immunohistochemistry and somatic mutations in EGFR, KRAS, BRAF, and PIK3CA, by direct sequencing. We also assessed the copy numbers of EGFR transcripts and the amplification of the EGFR gene in some of the samples. We found that EGFR, phosphorylated EGFR, MAPK, and phosphorylated MAPK were evidently expressed in 100, 54, 100, and 69% of the serous cystic neoplasms, and in 12%, none, 33, and 27% of the mucinous cystic neoplasms, respectively; the expression was significantly higher and more prevalent in the serous cystic neoplasms than in the mucinous cystic neoplasms. The expression of AKT and phosphorylated AKT was low in both the types of neoplasms. On average, EGFR transcripts in the serous cystic neoplasms and the mucinous cystic neoplasms increased 53.5-and 2.5-fold, respectively, as compared with that in normal tissues, with the increase in the former being significantly greater than that in the latter. Amplification of the EGFR gene was not detected in any of the examined serous cystic neoplasms. None of the tumors had mutations in any of the examined portions of the genes, except two mucinous cystic neoplasms with mutations in codon-12 of KRAS. These results indicate that EGFR and MAPK are actively involved in the pathobiology of serous cystic neoplasms and may therefore be potential diagnostic markers and therapeutic targets in patients with the above mentioned types of neoplasms.

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confidence: 99%

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Kuboki

Shiratori²,

Hatori³

et al. 2010

Modern Pathology

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“…8 In contrast, IPMN-P, which does not have ovarianlike stroma, occurs in both genders and has a communication to the pancreatic ductal system. 9 That is, most cases previously reported as pancreatic mucinous cystic neoplasms with a luminal communication to the pancreatic duct or occurring in male patients are now thought to be IPMN-P. 14,15 Recently, great attention is being drawn to intraductal biliary tumors. In 2001, we reported a characteristic intraductal papillary tumor of the bile duct associated with hepatolithiasis as a biliary counterpart of IPMN-P (intraductal papillary neoplasm of the bile duct: IPN-B).…”

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Biliary cystic tumors with bile duct communication: a cystic variant of intraductal papillary neoplasm of the bile duct

et al. 2006

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Biliary cystic tumors, which are also called biliary cystadenoma and cystadenocarcinoma, are thought to be a heterogeneous disease entity, and some of them are known to show a luminal communication to the bile duct. In this study, we examined the clinicopathological features of nine cases of biliary cystic tumors with bile duct communication. They were composed of five males and four females with an average age of 67 years (52-84 years). They were multilocular (eight cases) or unilocular (one case), and all cases contained mucinous fluid. A direct luminal communication with the bile ducts was identified in five cases on preoperative or intraoperative cholangiographies. Biliary cystic tumors examined in this study were histologically adenoma (one case), adenocarcinoma in situ (six cases), and adenocarcinoma associated with microinvasive mucinous carcinoma (two cases). One case of adenocarcinoma in situ also had the adenoma component (adenocarcinoma in adenoma). Dysplastic mucinous epithelium proliferated in flat, micropapillary and papillary fashions within the intracystic spaces. Intraepithelial neoplasm was observed within non-dilated adjacent bile ducts, suggesting a direct luminal communication between the cystic tumors and the bile duct. Ovarian-like stroma was not observed in their walls in any cases. Immunohistochemically, seven cases expressed MUC1 or MUC2 in the neoplastic biliary epithelium. All cases except one were alive without any evidences of tumor recurrence after total excision (3-156 months after surgery). These clinicopathological features resembled those of intraductal papillary neoplasm of the bile duct, which had been reported as a biliary counterpart of pancreatic intraductal papillary mucinous neoplasm. In conclusion, biliary cystic tumors with bile duct communication could be regarded as intraductal papillary neoplasm with a prominent cystic dilatation of the bile duct and mucin retention, rather than true biliary cystic neoplasms.

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“…It is believed that mucinous cystic neoplasms arise from the pancreatic ductal epithelium and predominantly occur in women with a mean age of 49 years. 16 Symptoms include epigastric pain/discomfort, anorexia, weakness, and weight loss. Mucinous neoplasms are comprised of large, multilocular, or occasionally unilocular cysts lined by tall, columnar, mucinproducing cells that often form papillae.…”

Section: Discussionmentioning

confidence: 99%

Microcystic adenoma of the pancreas

Lal

Bourtsos

DeFrias

et al. 2004

Cancer

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Mucinous Cystic Neoplasms of the Pancreas with Overt and Latent Malignancy (Cystadenocarcinoma and Cystadenoma): A Clinicopathologic Study of 41 Cases

Cited by 653 publications

References 0 publications

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Association of epidermal growth factor receptor and mitogen-activated protein kinase with cystic neoplasms of the pancreas

Biliary cystic tumors with bile duct communication: a cystic variant of intraductal papillary neoplasm of the bile duct

Microcystic adenoma of the pancreas

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