Pancreatic, hepatic, splenic, and mesenteric mucinous cystic neoplasms (MCN) are lumped together as extraovarian MCN

Shiono, Saori; Suda, Koichi; Nobukawa, Bunsei; Arakawa, Atsushi; Yamasaki, Shigetaka; Sasahara, Noriko; Hosokawa, Yoshinori; Suzuki, Fujihiko

doi:10.1111/j.1440-1827.2006.01926.x

Cited by 38 publications

(27 citation statements)

References 23 publications

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“…In doubtful cases (absence of ovarian stroma but no demonstrable communication with the main duct), it is better to classify these mucinous lesions as "indeterminate," rather than to include them with MCNs. 2The observation that MCNs of the pancreas predominantly affect women is in keeping with the fact that MCNs of the liver and retroperitoneum are also diagnosed mainly in females [23][24][25][26][27] and that MCNs can frequently be seen in ovaries 28,29 but rarely in the testis. 30 Zamboni et al 1 suggested that pancreatic MCNs may develop from endodermal immature stroma stimulated by female hormones 31 or from primary yolk cells implanted in the pancreas during embryogenesis.…”

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confidence: 91%

Mucinous Cystic Neoplasm of the Pancreas is Not an Aggressive Entity

Crippa¹,

Salvia²,

Warshaw³

et al. 2008

Annals of Surgery

431

310

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Objective-Mucinous cystic neoplasms (MCNs) of the pancreas have often been confused with intraductal papillary mucinous neoplasms. We evaluated the clinicopathologic characteristics, prevalence of cancer, and prognosis of a large series of well-characterized MCNs in 2 tertiary centers.Methods-Analysis of 163 patients with resected MCNs, defined by the presence of ovarian stroma and lack of communication with the main pancreatic duct.Results-MCNs were seen mostly in women (95%) and in the distal pancreas (97%); 25% were incidentally discovered. Symptomatic patients typically had mild abdominal pain, but 9% presented with acute pancreatitis. One hundred eighteen patients (72%) had adenoma, 17 (10.5%) borderline tumors, 9 (5.5%) in situ carcinoma, and 19 (12%) invasive carcinoma. Patients with invasive carcinoma were significantly older than those with noninvasive neoplasms (55 vs. 44 years, P = 0.01). Findings associated with malignancy were presence of nodules (P = 0.0001) and diameter ≥60 mm (P = 0.0001). All neoplasms with cancer were either ≥40 mm in size or had nodules. There was no operative mortality and postoperative morbidity was 49%. Median followup was 57 months (range, 4 -233); only patients with invasive carcinoma had recurrence. The 5-year disease-specific survival for noninvasive MCNs was 100%, and for those with invasive cancer, 57%. Conclusions-This PATIENTS AND METHODSThe MGH and UV Institutional Review Boards approved this study. Patients who underwent pancreatic resection between January 1988 and October 2005 for pathologically confirmed MCNs were identified from prospectively collected databases. Both presence of ovarian stroma and lack of communication with the main pancreatic duct were used as criterion to distinguish MCNs from IPMNs. 2,4 In the study period, 567 patients underwent surgery for mucinous tumors of the pancreas (305 MGH and 262 UV). Of these 163 (29%), 102 from UV and 61 from MGH, were determined to have MCNs, whereas the remaining patients had main-duct, branch-duct, or combined IPMNs, or indeterminate mucinous neoplasms. Information including demographics, clinical history, diagnostic work-up, type of surgery, postoperative course, pathology, and long-term follow-up were recorded. Perioperative mortality was defined as in-hospital or 30-day death.Tumors were classified according to the WHO criteria as MCNs with mild dysplasia (adenoma), with moderate dysplasia (borderline neoplasm), with high-grade dysplasia (carcinoma in situ), and MCN with invasive carcinoma. 4 In short, in MCN adenoma, the epithelium shows basally located nuclei with no increase in mitosis. In the borderline MCNs, the epithelium may exhibit papillary projections or crypt-like invagination, some nuclear pseudostratification with crowding and slightly enlarged nuclei. Mitoses can be observed. MCN with noninvasive carcinoma demonstrate high-grade dysplastic epithelial changes. The epithelium often forms papillae and irregular budding, as well as branching with nuclear stratification, severe nuclear a...

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confidence: 91%

Mucinous Cystic Neoplasm of the Pancreas is Not an Aggressive Entity

Crippa¹,

Salvia²,

Warshaw³

et al. 2008

Annals of Surgery

431

310

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“…Only 19 cases of primary cystadenocarcinoma of the mesentery have been reported in the world. Mesenteric cysts occur in patients of all ages, but they are considerably more common in women, and mesenteric mucinous cystic neoplasms (MCN) are simply regarded as extra-ovarian MCNs [7]. We investigated four cases of serous cystadenocarcinoma of the mesentery, excluding those of gynecological origin (Table 1; [3–6]).…”

Section: Discussionmentioning

confidence: 99%

Serous cystadenocarcinoma of the mesentery in a man: case report and review of literature

Obuchi

Shimooki²,

Sasaki

et al. 2014

Gastroenterology Report

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In February 2007, a 41-year-old Japanese male was admitted to our hospital with increasing upper abdominal pain. A contrast-enhanced computed tomography (CT) scan of the abdomen demonstrated a well-demarcated, hypodense cystic mass with a thickened wall in the mesocolon. The laboratory results were within normal limits, except for increased carcinoembryonic antigen, carbohydrate antigen 19-9, DUPAN-2 and SPAN-1. The patient was diagnosed as having a mesenteric malignant cyst, and during a laparotomy, a right hemicolectomy with mesenteric cystectomy was performed without rupture in March 2007. In the microscopic findings, there was a well-differentiated adenocarcinoma in the inner surface of the cyst and in the fibrous connective tissue of the hypertrophic cystic wall. The tumor cells were immunohistochemically reactive to cytokeratin (CK) 7, CK18 and CK20. No remnant of the malignancy was detected in the resected margin of the colon, cyst, liver or peritoneum nor was an uptake detected in an 18[F]-fluorodeoxyglucose positron emission tomography/CT examination of other organs. Finally, the malignancy was concluded to be a serous cystadenocarcinoma of the mesentery. Nineteen months after the operation, the patient died from peritonitis carcinomatosa due to a small intestine rupture. This report suggests mesenteric cystadenocarcinomas originating in the ovary, oviduct and intestinal mucosa, but these were ruled out in our patient. In this report, we discuss a case of the malignant transformation of a cyst into adenocarcinoma, which to our knowledge has never been previously reported in a male patient.

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“…The cyst is composed of an outer wall of ovarian-like stroma consisting of spindle-shaped cells and myofibroblastic proliferation and an inner layer of mucin-secreting columnar and cuboidal cells [5]. The identification of ovarian-like stroma on histological examination is diagnostic of mucinous cystadenomas, however, its absence does not preclude the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

A Mucinous Cystic Neoplasm of the Mesocolon Showing Features of Malignancy

Mistry

Penna

Dindyal

et al. 2012

Case Reports in Surgery

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Mucinous cystic neoplasms are rare tumours of uncertain histogenesis. They arise from the ovaries, pancreas, and other intra-abdominal sites but more unusually from the mesocolon. They can present with abdominal pain, distension, or a palpable mass but are commonly an incidental finding. We describe the case of a 48-year-old woman who was found to have an incidental left pelvic cyst on computed tomography. Subsequent laparoscopic excision and histological analysis demonstrated the cyst to be a borderline malignant mucinous tumour arising from the mesocolon. Mucinous tumours should be considered in the differential diagnosis of all intra-abdominal cysts and treatment should be by surgical complete excision.

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Pancreatic, hepatic, splenic, and mesenteric mucinous cystic neoplasms (MCN) are lumped together as extraovarian MCN

Cited by 38 publications

References 23 publications

Mucinous Cystic Neoplasm of the Pancreas is Not an Aggressive Entity

Mucinous Cystic Neoplasm of the Pancreas is Not an Aggressive Entity

Serous cystadenocarcinoma of the mesentery in a man: case report and review of literature

A Mucinous Cystic Neoplasm of the Mesocolon Showing Features of Malignancy

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