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Li Q, Zou C, Xu Y, Liu S, Yan T. Mucinous cystadenocarcinoma of the ovary in a 14-year-old girl: a case report and literature review. BMC Womens Health 2023; 23:382. [PMID: 37479970 PMCID: PMC10362768 DOI: 10.1186/s12905-023-02551-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/16/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Ovarian epithelial tumors are common in adults, and their peak incidence of onset is over 40 years of age. In children, most ovarian tumors are germ cell-derived, whereas epithelial tumors are rare and mostly benign. CASE PRESENTATION This report describes a case of a 14-year-old Chinese girl with ovarian mucinous cystadenocarcinoma. She was admitted with a small amount of bloody vaginal discharge during the past month. Magnetic resonance imaging of the abdomen and pelvis showed a large solid cystic mass lesion in the left ovary. Tumor marker levels were within normal limits ( CA-125: 22.3 U/mL, HE4: 28.5 pmol/L, HCG: < 1.20 mIU/ml, AFP: 3.3 ng/ml, CEA: 2.2 ng/ml, CA19-9: < 2.0 U/mL). Laparoscopic exploration revealed a large left ovarian tumor. The patient underwent left salpingo-oophorectomy, and showed no significant issues during follow-up, as well as no evidence of recurrence or metastasis. CONCLUSIONS We report the first pediatric case of ovarian mucinous cystadenocarcinoma in China. Given the scarcity of reports addressing the clinical management of this condition, the present study provides a useful contribution to its further understanding in light of developing future treatment strategies.
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Affiliation(s)
- Qiong Li
- Department of Pathology, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, No. 120 Longshan Rd, Yubei District, Chongqing, 401147, China
| | - Cancan Zou
- Department of Pathology, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, No. 120 Longshan Rd, Yubei District, Chongqing, 401147, China
| | - Yangyang Xu
- Department of Radiology, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Shiqing Liu
- Department of Ultrasound, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Tianjing Yan
- Department of Pathology, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, No. 120 Longshan Rd, Yubei District, Chongqing, 401147, China.
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Lei T, Shi YQ, Chen TB. Mammary mucinous cystadenocarcinoma with long-term follow-up: molecular information and literature review. Diagn Pathol 2023; 18:13. [PMID: 36737820 PMCID: PMC9898891 DOI: 10.1186/s13000-023-01302-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 01/19/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Mucinous cystadenocarcinoma (MCA) is a very rare form of breast cancer that was first described in 1998. Only 33 cases of primary MCA, including our present case, have been reported thus far. As a consequence, its molecular features, prognosis and treatment regimen are poorly known. Here, we describe a less common presentation of MCA, detail its molecular features, discuss the major differential diagnosis, and provide a brief review of the literature. CASE PRESENTATION A 59-year-old woman presented with a breast lump in which mammography showed a well-defined nodule. Core needle biopsy (CNB) revealed several lesions lined by tall columnar cells with stratification and abundant mucinous secretion; excision was recommended for final diagnosis. The resected specimens showed cavities of different sizes without surrounding myoepithelial cells. The cavities were rich in mucus, and the nuclei were located at the base of the cells, containing intracellular mucus. Immunohistochemical analysis revealed that it was triple-negative breast cancer (TNBC). Next-generation sequencing (NGS) revealed pathogenic mutations in the PIK3CA, KRAS, MAP2K4, RB1, KDR, PKHD1, TERT, and TP53 genes. A diagnosis of MCA was rendered. The patient has been followed up for 108 months to date and showed no signs of recurrence or metastasis. CONCLUSION Our study presents the gene profile of an MCA case with no recurrence or metastatic tendency after 108 months of follow-up, and a review of the literature helps us better understand the clinical, pathologic, and molecular features of this tumor.
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Affiliation(s)
- Ting Lei
- grid.452253.70000 0004 1804 524XDepartment of Pathology, The Third Affiliated Hospital of Soochow University, Ju Qian Street 185, Changzhou, 213003 Jiangsu China
| | - Yong Qiang Shi
- grid.452253.70000 0004 1804 524XDepartment of Pathology, The Third Affiliated Hospital of Soochow University, Ju Qian Street 185, Changzhou, 213003 Jiangsu China
| | - Tong Bing Chen
- grid.452253.70000 0004 1804 524XDepartment of Pathology, The Third Affiliated Hospital of Soochow University, Ju Qian Street 185, Changzhou, 213003 Jiangsu China
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Tezuka S, Ueno M, Kobayashi S, Fukushima T, Nasu R, Washimi K, Yamamoto N, Morinaga S, Morimoto M, Maeda S. A case of pancreatic mucinous cystadenocarcinoma with malignant ascites without recurrence for more than 8 years after surgery. Clin J Gastroenterol 2022; 15:834-839. [PMID: 35546381 PMCID: PMC9334409 DOI: 10.1007/s12328-022-01639-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/25/2022] [Indexed: 11/04/2022]
Abstract
Mucinous cystadenocarcinoma (MCAC) with malignant ascites is rare. We report a case of a 28-year-old woman who presented with epigastric pain. The ascites in the Douglas fossa was identified at a nearby gynecology clinic. Computed tomography showed a multiloculated cystic lesion (9.5 × 6.4 cm) in the tail of the pancreas, which was diagnosed as mucinous cystic neoplasm on imaging. Staging laparoscopy was performed, and rapid cytology of ascites revealed adenocarcinoma, leading to a diagnosis of unresectable MCAC. Subsequently, combination chemotherapy with gemcitabine plus S-1 was initiated. Although there were no remarkable changes in the imaging findings, the peritoneal dissemination node was not consistently recognized in any of the imaging findings, and distal pancreatectomy was performed. A peritoneal dissemination node was not observed in the laparotomy findings, but the peritoneal lavage cytology was positive. The postoperative pathological result was non-invasive MCAC, and the ascites was suspected to be caused by cyst rupture. The patient has been recurrence-free, including the reappearance of ascites, for > 8 years after adjuvant therapy with S-1. Although careful follow-up will be required in the future, the very good prognosis in this case suggests that MCAC with malignant ascites without obvious peritoneal dissemination should be considered for surgical resection.
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Affiliation(s)
- Shun Tezuka
- Department of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama City, 241-8515, Japan.
| | - Makoto Ueno
- Department of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama City, 241-8515, Japan
| | - Satoshi Kobayashi
- Department of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama City, 241-8515, Japan
| | - Taito Fukushima
- Department of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama City, 241-8515, Japan
| | - Ryuji Nasu
- Department of Clinical Laboratory, Kanagawa Cancer Center, Yokohama, Japan
| | - Kota Washimi
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Naoto Yamamoto
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Soichiro Morinaga
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Manabu Morimoto
- Department of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama City, 241-8515, Japan
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Kamrani G, Nikbakhsh N, Hosseini A, Ghorbani H, Arefisigaroudi N, Davarian A. Mucinous cystadenocarcinoma of breast in a 69-year-old woman with positive hormone receptors, the first case reported. Caspian J Intern Med 2021; 12:S444-S446. [PMID: 34760102 PMCID: PMC8559632 DOI: 10.22088/cjim.12.0.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 11/17/2022]
Abstract
Background: Mucinous cystadenocarcinoma is a relatively uncommon histological subtype of breast cancer that is a cystic form of papillary mucinous carcinoma. It is regularly negative for estrogen and progesterone receptors and it is most often diagnosed in older than 55-60 years old. The incidence of breast mucinous cystadenocarcinoma is about 1-6% of primary breast cancers. Here, we present a case of breast mucinous cystadenocarcinoma of left breast in a 69-year-old female which is positive for estrogen and progesterone receptors. Case Presentation: In this article, we describe a case of a-69-year-old female with a painful mass in her left breast. Based on intraoperative pathology consult, neoplastic tissue mostly floating in mucinous lakes with invasion to surrounding stroma was seen. Immunohistochemistry profile showed positive estrogen and progesterone receptors and negative for HER2. Conclusion: Mucinous cystadenocarcinoma of breast is typically triple negative for hormone receptors. But ER and PR positive variant of this tumor is rare, giving the chance of a better prognosis for the patient with hormonal therapy.
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Affiliation(s)
- Ghodsieh Kamrani
- Department of Pathology, Cancer Research Institute, Babol University of Medical Science, Babol , Iran
| | - Novin Nikbakhsh
- Department of surgery, Cancer Research Institute, Babol University of Medical Sciences, Babol , Iran
| | - Akarm Hosseini
- Department of Pathology, Cancer Research Institute, Babol University of Medical Science, Babol , Iran
| | - Hossein Ghorbani
- Department of Pathology, Cancer Research Institute, Babol University of Medical Science, Babol , Iran
| | - Niloufar Arefisigaroudi
- Department of Pathology, School of medicine, Babol University of Medical Sciences, Babol, Iran
| | - Ali Davarian
- Ischemic Disorders Research Center, Golestan University of Medical Science, Gorgan, Iran
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Dhali A, Ray S, Khamrui S, Dhali GK. Mucinous cystadenocarcinoma of pancreas mimicking gastrointestinal stromal tumor of stomach: Case report. Int J Surg Case Rep 2021; 85:106240. [PMID: 34343789 PMCID: PMC8349996 DOI: 10.1016/j.ijscr.2021.106240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 07/23/2021] [Accepted: 07/24/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Pancreatic mucinous cysadenocarcinoma is a rare neoplasm of pancreas which rarely presents as upper gastrointestinal bleed. Case report A 45-year-old woman presented with history of repeated episodes of melena and abdominal pain. Upper gastrointestinal endoscopy revealed a growth in the body of the stomach likely to be a gastrointestinal stromal tumor (GIST). Endoscopic biopsy was inconclusive for GIST or malignancy. Computed tomography scan of the abdomen showed a well-defined multiloculated cystic lesion (11.8 × 11.1 × 6.4 cm) in the body and tail of the pancreas with involvement of the stomach. Preoperative diagnosis was a cystic neoplasm of the pancreas with tumor ingrowth into the stomach. The patient underwent enbloc resection of the stomach with distal pancreatectomy and splenectomy. Histopathological examination revealed low grade mucinous cystadenocarcinoma of the pancreas. Discussion Upper gastrointestinal bleed as a manifestation of cystic neoplasms of pancreas are rarely reported. Although some cases of hemoperitoneum were reported due to rupture of tumor; luminal gastrointestinal bleed is even rarer. It may be due to involvement of porto-mesenteric axis with portal hypertension, direct invasion of the gastric wall with ulceration of the gastric mucosa, communication between the tumor and the main pancreatic duct, and from the infiltrating tumor. Conclusion Our case highlights the fact that mucinous cystadenocarcinoma of pancreas rarely can present with upper gastrointestinal hemorrhage, Moreover, if it is large enough to compress or invade the stomach, endoscopy may misdiagnose it as GIST. Mucinous cystadenocarcinoma of pancreas; is a rare pacreatic neoplasm which can present with upper gastrointestinal hemorrhage. If it is large enough to compress or invade the stomach, endoscopy may misdiagnose it as gastrointestinal stromal tumor. Clinicians should be aware of this atypical manifestation and correlate with cross-sectional imaging accordingly.
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Affiliation(s)
- Arkadeep Dhali
- Department of GI Surgery, IPGME&R, School of Digestive & Liver Diseases, Kolkata, India
| | - Sukanta Ray
- Department of GI Surgery, IPGME&R, School of Digestive & Liver Diseases, Kolkata, India.
| | - Sujan Khamrui
- Department of GI Surgery, IPGME&R, School of Digestive & Liver Diseases, Kolkata, India
| | - Gopal Krishna Dhali
- Department of Gastroenterology, IPGME&R, School of Digestive & Liver Diseases, Kolkata, India
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Marco MD, Carloni R, Lorenzo SD, Mosconi C, Palloni A, Grassi E, Filippini DM, Ricci AD, Rizzo A, Federico AD, Santini D, Turchetti D, Ricci C, Ingaldi C, Alberici L, Minni F, Golfieri R, Brandi G, Casadei R. Pancreatic mucinous cystadenocarcinoma in a patient harbouring BRCA1 germline mutation effectively treated with olaparib: A case report. World J Gastrointest Oncol 2020; 12:1456-1463. [PMID: 33362915 PMCID: PMC7739147 DOI: 10.4251/wjgo.v12.i12.1456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/01/2020] [Accepted: 11/10/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pancreatic mucinous cystadenocarcinoma (MCAC) is a rare malignancy with a poor prognosis when it presents metastases at diagnosis. Due to its very low incidence, there are no clear recommendations for the treatment of advanced disease. Olaparib (an oral PARP inhibitor) has been approved for the maintenance treatment of patients with metastatic pancreatic adenocarcinoma harbouring germline BRCA1/2 mutations. Herein, we report the first case of a germline BRCA1 mutated unresectable MCAC which was effectively treated with olaparib.
CASE SUMMARY A 41-year-old woman, without personal or family history of cancer, was diagnosed with ovarian and peritoneal metastases of MCAC. She underwent 12 cycles of gemcitabine plus oxaliplatin (GEMOX) obtaining a partial response and allowing radical surgery. One year later, local recurrence was documented, and other 12 cycles of GEMOX were administered obtaining a complete response. Seven years later, another local recurrence, not amenable to surgical resection, was diagnosed. She started FOLFIRINOX (oxaliplatin, irinotecan, leucovorin and fluorouracil), obtaining a partial response after 8 cycles. Given the excellent response to platinum-based chemotherapy, BRCA testing was performed, and a BRCA1 germline mutation was detected. She was switched to maintenance olaparib due to chemotherapy-related toxicities and achieved an almost complete metabolic response, with a reduction in the diameter of the lesion, after three months of therapy.
CONCLUSION The current case suggests the beneficial effect of olaparib in BRCA mutated MCAC. However, further studies are required.
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Affiliation(s)
- Mariacristina Di Marco
- Department of Experimental, Diagnostic, and Specialty Medicine-DIMES, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
- Division of Oncology, Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Riccardo Carloni
- Department of Experimental, Diagnostic, and Specialty Medicine-DIMES, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Stefania De Lorenzo
- Division of Oncology, Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Cristina Mosconi
- Radiology Unit, Department of Diagnostic Medicine and Prevention, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Andrea Palloni
- Department of Experimental, Diagnostic, and Specialty Medicine-DIMES, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Elisa Grassi
- Medical Oncology, Ospedale Degli Infermi, Faenza 48018, Italy
| | - Daria Maria Filippini
- Department of Experimental, Diagnostic, and Specialty Medicine-DIMES, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Angela Dalia Ricci
- Department of Experimental, Diagnostic, and Specialty Medicine-DIMES, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Alessandro Rizzo
- Department of Experimental, Diagnostic, and Specialty Medicine-DIMES, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Alessandro Di Federico
- Department of Experimental, Diagnostic, and Specialty Medicine-DIMES, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | | | - Daniela Turchetti
- Unit of Medical Genetics, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Claudio Ricci
- Division of Pancreatic Surgery, Azienda Ospedaliero-Universitaria Di Bologna, Bologna 40138, Italy
- Department of Internal Medicine and Surgery, Alma Mater Studiorum, University of Bologna, Bologna 40138, Italy
| | - Carlo Ingaldi
- Division of Pancreatic Surgery, Azienda Ospedaliero-Universitaria Di Bologna, Bologna 40138, Italy
- Department of Internal Medicine and Surgery, Alma Mater Studiorum, University of Bologna, Bologna 40138, Italy
| | - Laura Alberici
- Division of Pancreatic Surgery, Azienda Ospedaliero-Universitaria Di Bologna, Bologna 40138, Italy
- Department of Internal Medicine and Surgery, Alma Mater Studiorum, University of Bologna, Bologna 40138, Italy
| | - Francesco Minni
- Division of Pancreatic Surgery, Azienda Ospedaliero-Universitaria Di Bologna, Bologna 40138, Italy
- Department of Internal Medicine and Surgery, Alma Mater Studiorum, University of Bologna, Bologna 40138, Italy
| | - Rita Golfieri
- Radiology Unit, Department of Diagnostic Medicine and Prevention, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | - Giovanni Brandi
- Department of Experimental, Diagnostic, and Specialty Medicine-DIMES, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
- Division of Oncology, Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy
| | - Riccardo Casadei
- Division of Pancreatic Surgery, Azienda Ospedaliero-Universitaria Di Bologna, Bologna 40138, Italy
- Department of Internal Medicine and Surgery, Alma Mater Studiorum, University of Bologna, Bologna 40138, Italy
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Tamsin A, Schillebeeckx C, Van Langenhove C, Vander Eeckt K, Ost D, Wetzels K. Mucinous cystadenocarcinoma in the renal pelvis: primary or secondary? Case report and literature review. Acta Chir Belg 2020; 120:417-424. [PMID: 31084406 DOI: 10.1080/00015458.2019.1617515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Cystic lesions in the renal pelvis may cause a diagnostic dilemma. These lesions may be benign or (pre)malignant and primary of secondary. CASE REPORT A 65-year-old woman presents with a complex cystic mass in the lower pole of the left kidney measuring approximately 16 cm in size and classified as Bosniak type 2F with minimally thickened septa and thick calcifications on non-contrast-enhanced computed tomography. The histopathological findings are consistent with a mucinous cystadenocarcinoma in the renal pelvis. Given the absence of a primary focus and based on clinical and radiological examination, the diagnosis of a primary renal neoplasm is preferred. DISCUSSION A review of the literature is performed to evaluate the histological differential diagnosis and confirm the diagnosis. Epidemiology with an overview of available similar cases since 2009, as well as etiological factors, treatment and prognosis was reviewed. CONCLUSION Primary renal mucinous cystadenocarcinoma is an exceedingly rare tumor. Histopathology still remains the gold standard for the diagnosis of this tumor. Because of the rarity, secondary involvement from more common sites, such as ovary and gastrointestinal tract, should be thoroughly excluded.
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Affiliation(s)
- An Tamsin
- Department of Pathology, AZ Sint-Blasius, Dendermonde, Belgium
| | | | | | | | - Dieter Ost
- Department of Urology, AZ Sint-Blasius, Dendermonde, Belgium
| | - Kevin Wetzels
- Department of Radiology, AZ Sint-Blasius, Dendermonde, Belgium
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Zhao ZM, Jiang N, Gao YX, Yin ZZ, Zhao GD, Tan XL, Xu Y, Liu R. Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: Single-center experience with 82 patients. World J Gastrointest Oncol 2020; 12:642-650. [PMID: 32699579 PMCID: PMC7340995 DOI: 10.4251/wjgo.v12.i6.642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Mucinous cystic neoplasm (MCN) of the pancreas is characterized by mucin-producing columnar epithelium and dense ovarian-type stroma and at risk for malignant transformation. Early diagnosis and treatment of MCN are particularly important.
AIM To investigate the clinical characteristics of and management strategies for pancreatic mucinous cystadenoma (MCA) and mucinous cystadenocarcinoma (MCC).
METHODS The clinical and pathological data of 82 patients with pancreatic MCA and MCC who underwent surgical resection at our department between April 2015 and March 2019 were retrospectively analyzed.
RESULTS Of the 82 patients included in this study, 70 had MCA and 12 had MCC. Tumor size of MCC was larger than that of MCA (P = 0.049). Age and serum levels of tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and CA12-5 were significantly higher in MCC than in MCA patients (P = 0.005, 0.026, and 0.037, respectively). MCA tumor size was positively correlated with serum CA19-9 levels (r = 0.389, P = 0.001). Compared with MCC, MCA had a higher minimally invasive surgery rate (P = 0.014). In the MCA group, the rate of major complications was 5.7% and that of clinically relevant pancreatic fistula was 8.6%; the corresponding rates in the MCC group were 16.7% and 16.7%, respectively.
CONCLUSION Tumor size, age, and serum CEA, CA19-9, and CA12-5 levels may contribute to management of patients with MCN. Surgical resection is the primary treatment modality for MCC and MCA.
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Affiliation(s)
- Zhi-Ming Zhao
- Second Department of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Nan Jiang
- Second Department of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yuan-Xing Gao
- Second Department of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Zhu-Zeng Yin
- Second Department of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Guo-Dong Zhao
- Second Department of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Xiang-Long Tan
- Second Department of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yong Xu
- Second Department of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Rong Liu
- Second Department of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
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Vasantham V, Yadav SK, Sarin N, Singh S, Pruthi SK. Incidental detection of microfilaria in cyst fluid of Mucinous cystadenocarcinoma of ovary: A rare case report. Int J Surg Case Rep 2020; 70:56-59. [PMID: 32416487 PMCID: PMC7229237 DOI: 10.1016/j.ijscr.2020.04.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/03/2020] [Accepted: 04/20/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Filariasis is a major health problem in certain parts of India. Microfilaria detection on exfoliative and fluid cytology is extremely rare and it is even very rare to find microfilaria coexistent with neoplastic lesions. PRESENTATION OF CASE A 45-year-old nulliparous female, who presented with complaints of lower abdominal swelling and pain. Initially, a clinical diagnosis of cystadenoma was made. Ascitic fluid cytology of the patient showed 3-dimensional clusters of cells along with an occasional microfilaria. On histopathology, a diagnosis of Mucinous cystadenocarcinoma of ovary was made. DISCUSSION Most common cause of lymphatic filariasis is W. bancrofti followed by Brugia species and it affects young adults. The adult form of the filaria lodge in lymph vessels, and due to lymphatic blockage in neoplasms they appear in tissue fluid or on surface material. It is the first case report of microfilaria being detected in ovarian cystic fluid cytology in a patient of Mucinous cystadenocarcinoma of ovary. CONCLUSION Filaria is an incidental finding in most of the cases, hence, cytopathologist should be vigilant and careful screening of all the slides should be done, especially in a country like India, where it is highly endemic.
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Affiliation(s)
- Vyshnavi Vasantham
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Shakti Kumar Yadav
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Namrata Sarin
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Sompal Singh
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Sonam Kumar Pruthi
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India.
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Tsoukalas N, Kiakou M, Tolia M, Kostakis ID, Galanopoulos M, Nakos G, Tryfonopoulos D, Kyrgias G, Koumakis G. Mucinous breast carcinoma with tall columnar cells. Ann R Coll Surg Engl 2018; 100:e132-e135. [PMID: 29658333 DOI: 10.1308/rcsann.2018.0060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Mucinous carcinoma of the breast represents 1%-4% of all breast cancers. The World Health Organization classification divides this type of tumour into three different subtypes: mucinous carcinoma, mucinous carcinoma with tall columnar cells (mucinous cystadenocarcinoma and columnar cell mucinous carcinoma) and signet ring cell carcinoma. A 74-year-old woman presented a tumour with inflammatory features in the upper outer quadrant of her left breast, 7 cm in diameter. The core biopsy showed infiltrating ductal carcinoma of no specific type. The tumour-node-metastasis clinical staging was T4cN3M0 (Stage IIIC). She received neoadjuvant chemotherapy, underwent left mastectomy with radical axillary resection and subsequently received radiotherapy and chemotherapy. The histological examination of the surgical specimen revealed two solid tumors in the tail of Spence, which corresponded to adenocarcinoma with high columnar cells. The patient died 16 months after the diagnosis, suffering from pulmonary metastases and anterior chest wall infiltration. A review of the literature revealed only 21 reports of mucinous carcinoma of the breast with tall columnar cells, including our case. This is only the third time that the specific histological type of columnar cell mucinous carcinoma has been reported in the literature.
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Affiliation(s)
- N Tsoukalas
- Department of Oncology, 401 General Military Hospital , Athens , Greece.,Second Department of Medical Oncology, Agios Savvas Anticancer Hospital , Athens , Greece.,Contributed equally
| | - M Kiakou
- Department of Oncology, 401 General Military Hospital , Athens , Greece.,Contributed equally
| | - M Tolia
- Department of Radiotherapy, University of Thessaly, Medical School , Larissa , Greece
| | - I D Kostakis
- Second Department of Propedeutic Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - M Galanopoulos
- Department of Oncology, 401 General Military Hospital , Athens , Greece
| | - G Nakos
- Department of Pathology, 401 General Military Hospital , Athens , Greece
| | - D Tryfonopoulos
- Second Department of Medical Oncology, Agios Savvas Anticancer Hospital , Athens , Greece
| | - G Kyrgias
- Department of Radiotherapy, University of Thessaly, Medical School , Larissa , Greece
| | - G Koumakis
- Second Department of Medical Oncology, Agios Savvas Anticancer Hospital , Athens , Greece
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11
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Koufopoulos N, Goudeli C, Syrios J, Filopoulos E, Khaldi L. Mucinous cystadenocarcinoma of the breast: the challenge of diagnosing a rare entity. Rare Tumors 2017; 9:7016. [PMID: 29081926 PMCID: PMC5643878 DOI: 10.4081/rt.2017.7016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 06/01/2017] [Accepted: 08/17/2017] [Indexed: 11/25/2022] Open
Abstract
Mucinous cystadenocarcinoma is an extremely rare variant of primary breast tumor which is histologically similar to mucinous cystadenocarcinoma of the ovary and pancreas. Herein we report a case of a 63 years old woman diagnosed with diverse histological types of non-synchronous rare primary breast tumors, a medullary carcinoma of the right breast and a mucinous cystadenocarcinoma of the left breast. Macroscopically the neoplasm appeared multilocular filled with mucoid material. Under light microscopy the cystic areas were lined by columnar cells with abundant intracellular and extracellular mucin. Solid areas were composed of tall columnar cells with intracellular mucin. Moderate to marked atypia was noticed and tumor cells stained positive for cytokeratin 7 and negative for cytokeratin 20. Moreover tumor cells displayed a basal like immunophenotype expressed as followed: ER negative, PR negative, HER-2 negative, cytokeratin (CK5/6) positive and EGFR positive.
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12
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Seong M, Ko EY, Han BK, Cho SY, Cho EY, Lee SK, Lee JE. Radiologic Findings of Primary Mucinous Cystadenocarcinoma of the Breast: A Report of Two Cases and a Literature Review. J Breast Cancer 2016; 19:330-333. [PMID: 27721884 PMCID: PMC5053319 DOI: 10.4048/jbc.2016.19.3.330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/27/2016] [Indexed: 11/30/2022] Open
Abstract
Primary mucinous cystadenocarcinoma (MCA) of the breast is a rare but pathologically distinct breast tumor. There have been some case reports on primary MCA of the breast; however, they have all focused on pathologic findings. Here, we report the radiologic findings of two cases of MCA along with a review of the literature. Breast MCA shows a circumscribed mass with some calcifications on mammography, an intracystic solid mass without increased vascularity or a vascular stalk on ultrasound, and a heterogeneously enhancing mass within a rim-enhancing cyst with intermediate signal intensity on T2-weighted magnetic resonance imaging. These radiologic findings and the presence of mucin in the percutaneous biopsy specimen should suggest the possibility of MCA in the differential diagnosis of a breast tumor.
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Affiliation(s)
- Minjung Seong
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Young Ko
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Boo-Kyung Han
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Youn Cho
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Yoon Cho
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Kyung Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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13
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Doulamis IP, Mylonas KS, Kalfountzos CE, Mou D, Haj-Ibrahim H, Nasioudis D. Pancreatic mucinous cystadenocarcinoma: Epidemiology and outcomes. Int J Surg. 2016;35:76-82. [PMID: 27638187 DOI: 10.1016/j.ijsu.2016.09.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/30/2016] [Accepted: 09/11/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pancreatic mucinous cystadenocarcinoma is a rare malignancy. Our aim was to investigate the demographic, pathological characteristics, treatment modalities and survival of patients with mucinous cystadenocarcinoma via the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) database analysis. MATERIALS AND METHODS This was a retrospective study of SEER database's records on patients with mucinous cystadenocarcinoma diagnosed from 1988 to 2012. Primary outcome measures were clinico-pathological characteristics, observed and disease-specific survival. RESULTS A total of 507 patients were identified. Median age at diagnosis was 67 years and most patients were female (68.4%). The tumors were mainly low grade (82.9%, grade I-II) and frequently localized (42.8%) in the body/tail of the pancreas (45.6%). According to Kaplan-Meier curves observed survival was 111 months (95%CI: 82.5, 139.5) vs 14 months (95% CI: 10.9, 17.1) vs 4 months (95%CI: 2.9, 5.1) for patients with localized, regional and distant disease, respectively. One-year disease-specific survival for patients with localized disease was 90.1%, vs. 56.7% for those with regional and 18.7% with distant tumor spread. CONCLUSIONS Mucinous cystadenocarcinomas tend to be low grade tumors, localized to the pancreatic body/tail. Surgery as the primary therapeutic intervention and tumor stage are independent predictors of disease-specific survival.
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14
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Myriokefalitaki E, Luqman I, Potdar N, Brown L, Steward W, Moss EL. Primary retroperitoneal mucinous cystadenocarcinoma (PRMCa): a systematic review of the literature and meta-analysis. Arch Gynecol Obstet 2015; 293:709-20. [PMID: 26681306 DOI: 10.1007/s00404-015-3975-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 11/24/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Primary retroperitoneal mucinous cystadenocarcinoma (PRMCa) is a rare tumour. Prognosis and optimal management are not well established. In view of a case managed in our Centre, we performed a systematic review and meta-analysis. METHOD Systematic review of medical electronic databases for published data (1950-12/10/2015). No RCTs identified. Individual patient data detracted from case reports and case series were analysed RESULTS In total, 73 female and 5 male cases of PRMCa identified including our case. Median age at diagnosis was 42.0 years (range 18-86 years), with women being significantly younger than men at diagnosis (42.0 years versus 62.2 years, p = 0.005). A palpable abdominal mass and abdominal pain were the most common presentations in 42.9 and 23.8 % of cases, respectively. Twenty-six women were <38 years old. There were 16 women <38 years old that had surgical data reported, of which 14 underwent fertility-sparing surgery with excision of the mass. Adjuvant chemotherapy was given in 24.1 % (13/72) women. Follow-up ranged from 1 to 130 months with a median of 15 months. Of the 57 cases that had follow-up reported, recurrence occurred in 23 cases (40.4 %) within a median of 8 months from diagnosis. Median disease-free survival was 15 months (range 1-130 months). Of the women who recurred, 14 died of their disease giving 1, 2 and 5-year disease-specific survival rates of 85.9, 80.7 and 75.4 %, respectively. CONCLUSION PRMCa are rare and potentially aggressive tumours that often occur in young women. Removal of the tumour, adequate staging and adjuvant chemotherapy needs to be considered.
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Affiliation(s)
- E Myriokefalitaki
- Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK.
| | - I Luqman
- Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK
| | - N Potdar
- Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK
| | - L Brown
- Department of Pathology, University Hospitals of Leicester, Leicester, UK
| | - W Steward
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| | - E L Moss
- Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK.,Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
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15
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Wu RL, Ali S, Sarkar FH, Beydoun R. Identification of Differentially Expressed miRNAs in Appendiceal Mucinous Cystadenocarcinoma from Mucinous Cystadenoma. ACTA ACUST UNITED AC 2015; 7:328-335. [PMID: 26807210 PMCID: PMC4720386 DOI: 10.4172/1948-5956.1000371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective Mucinous cystadenocarcinoma of appendix is a rare entity. Differentiating mucinous cystadenocarcinoma from mucinous cystadenoma is very challenging and depends on establishing the presence of malignant cells in the appendix wall. The invasion may be very difficult to assess in some cases, especially in early stages of the disease, which could have devastating prognostic effects on patients. Therefore, it is necessary to develop an ancillary test that can differentiate the mucinous cystadenocarcinoma from mucinous cystadenoma. So far, there is no report available about the role of differentially expressed miRNAs in the diagnosis of appendiceal mucinous cystadenocarcinoma. Materials and Methods Six confirmed mucinous appendiceal cystadenocarcinoma and twelve mucinous appendiceal cystadenoma cases were selected. The total RNAs were extracted from the formalin-fixed paraffin-embedded specimen of these cases. The comprehensive miRNA microarray expression profiling from pooled aliquots of RNA samples from these two entities were analyzed to detect the differentially expressed miRNAs in mucinous cystadenocarcinoma. The best seven differentially expressed miRNAs were validated in individual cases by quantitative reverse transcriptase PCR (qRT-PCR). Results The microarray miRNA expression profiling analysis revealed 646 miRNAs that were differentially expressed in the mucinous cystadenocarcinoma. Among these differentially expressed miRNAs, the expression of 80 miRNAs showed statistical difference (p<0.01). The quantitative RT-PCR validated that the expression of miR-1, miR-4328 was significantly down regulated in mucinous cystadenocarcinoma compared to the mucinous cystadenoma (p<0.05). On the other hand, the expression of miR-200b, miR-200c, miR-451, miR-223 and miR-21 were significantly upregulated in mucinous cystadenocarcinoma (p<0.05). Conclusion The expression levels of miRNAs tested were significantly altered in the appendiceal mucinous cystadenocarcinoma samples compared to the mucinous cystadenoma. These data suggest that the miRNA expression in mucinous appendiceal neoplasm may help to supplement the morphological evaluation in distinguishing benign from malignant tumors.
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Affiliation(s)
- Richard Licheng Wu
- Department of Pathology, Jackson Memorial Hospital, University of Miami, Miami, Florida, USA
| | - Shadan Ali
- Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Fazlul H Sarkar
- Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, USA; Department of Pathology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Rafic Beydoun
- Department of Pathology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
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16
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Abstract
Retroperitoneal mucinous cystadenomas are rare lesions (less than 50 reported) characterized by presence of ovary like stroma of unknown origin. However, germinal component of ovary has never been found in them. The pancreas occasionally gives rise to mucinous cystadenomas, but they are always intrapancreatic. We report a unique case of a rare retroperitoneal mucinous cystadenomas with presence of ovarian follicles in a 45-year-old lady who presented with an abdominal mass. This was successfully excised. Though retroperitoneal mucinous cystadenomas are rare, presence of ovarian follicle (germ cell) in them has never been reported before.
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Affiliation(s)
- Soumyo Ranjan Acharya
- Department of Surgery, R.G. Kar Medical College, P318.B.C.I.T road. Kankurgachi, Kolkata, 700054 India
| | - Prosenjit Dasgupta
- Department of Surgery, R.G. Kar Medical College, P318.B.C.I.T road. Kankurgachi, Kolkata, 700054 India
| | - Subhobroto Das
- Department of Surgery, R.G. Kar Medical College, P318.B.C.I.T road. Kankurgachi, Kolkata, 700054 India
| | - Sandip Halder
- Department of Surgery, R.G. Kar Medical College, P318.B.C.I.T road. Kankurgachi, Kolkata, 700054 India
| | - Nilanjan Panda
- Department of Surgery, R.G. Kar Medical College, P318.B.C.I.T road. Kankurgachi, Kolkata, 700054 India
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17
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Nakatani K, Tokuhara K, Sakaguchi T, Ryota H, Yoshioka K, Kon M. Low-grade mucinous neoplasia in a cecal diverticulum: A case report. Int J Surg Case Rep 2015; 15:66-9. [PMID: 26318130 PMCID: PMC4601971 DOI: 10.1016/j.ijscr.2015.08.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/04/2015] [Accepted: 08/15/2015] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION Low-grade mucinous neoplasia is an uncommon benign tumor that develops in the appendix. The development of mucocele disease has never been reported in a colonic diverticulum. We present a case developing low-grade mucinous neoplasia in a cecal diverticulum. PRESENTATION OF CASE A tumor in the ileocecal region was found during a medical examination of a 66-year-old woman. Three months later, the tumor was still present and the patient developed abdominal pain. Laparoscopic ileocecal resection with D2 lymph node dissection was performed. Histopathological examination revealed a low-grade mucinous neoplasm in a cecal diverticulum. DISCUSSION Colonic mucoceles reportedly originate from the appendix. There are no previous reports of mucocele disease in a colonic diverticulum worldwide. This report reviews and discusses the management of the appendiceal mucoceles. CONCLUSION The incidence of colonic diverticula has recently begun to increase in Japan. The possibility of a mucocele within a colonic diverticulum should be considered in patients with submucosal colonic tumors.
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Affiliation(s)
- Kazuyoshi Nakatani
- Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka 570-8507, Japan.
| | - Katsuji Tokuhara
- Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka 570-8507, Japan.
| | - Tatsuma Sakaguchi
- Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka 570-8507, Japan.
| | - Hironori Ryota
- Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka 570-8507, Japan.
| | - Kazuhiko Yoshioka
- Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka 570-8507, Japan.
| | - Masanori Kon
- Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka 570-8507, Japan.
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18
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Kamiyama H, Shimazu A, Makino Y, Ichikawa R, Hobo T, Arima S, Nohara S, Sugiyama Y, Okumura M, Takei M, Miura H, Namekata K, Tsumura H, Okada M, Takase M, Matsumoto F. Report of a case: Retroperitoneal mucinous cystadenocarcinoma with rapid progression. Int J Surg Case Rep 2015; 10:228-31. [PMID: 25884614 PMCID: PMC4430186 DOI: 10.1016/j.ijscr.2015.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/08/2015] [Accepted: 04/03/2015] [Indexed: 10/30/2022] Open
Abstract
INTRODUCTION Retroperitoneal mucinous cystic neoplasms are uncommon, and little is known about the etiology of the disease. Malignant forms of these are extremely rare. Here, we report a case of primary retroperitoneal mucinous cystadenocarcinoma (PRMC), which demonstrated unexpectedly aggressive progression despite finding only a limited area of adenocarcinoma. PRESENTATION OF CASE A 62-year-old woman with a complaint of abdominal discomfort was admitted to the hospital. Abdominal CT and MRI showed multiple large retroperitoneal cysts dislocating the right kidney nearly to the center of the abdomen. Transabdominal resection of the cysts was performed. Those cysts contained 1100ml of mucinous fluids in total. Cytological examination of those fluids revealed no malignant cells. The cyst wall was lined with mucinous epithelial cells, and contained some ovarian-type stroma. Also, there was a focal area of adenocarcinoma in the cyst wall, and the lesion was diagnosed as primary retroperitoneal mucinous cystadenocarcinoma. Eight months later, the patient developed lumbar bone metastasis. Chemotherapy with S-1, an oral fluoropyrimidine, and docetaxel had been begun immediately; however, the disease had rapidly spread in the retroperitoneum. Eventually, the patient died of the disease 15 months after surgery. DISCUSSION Retroperitoneal mucinous cystic neoplasms are considered to be metaplasia of embryonal coelomic epithelium. Complete excision without rupture is essential. However, variance of biological aggressiveness might exist in PRMCs. CONCLUSION Retroperitoneal mucinous cystadenocarcinoma is a rare tumor, and it is urgently necessary to elucidate the etiology of an effective therapy for the disease.
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Affiliation(s)
- Hirohiko Kamiyama
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan.
| | - Ai Shimazu
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Yurika Makino
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Ryosuke Ichikawa
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Takahiro Hobo
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Shuei Arima
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Shigeo Nohara
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Yuji Sugiyama
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Masafumi Okumura
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Masahiko Takei
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Hiroyoshi Miura
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Koji Namekata
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Hidenori Tsumura
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Motoi Okada
- Department of Pathology, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Masaru Takase
- Department of Pathology, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
| | - Fumio Matsumoto
- Department of Surgery, Koshigaya Municipal Hospital, Higashikoshigaya 10-47-1, Koshigayashi, Saitama 343-8577, Japan
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19
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Kim SH, Yuk HD, Park WS, Kim SH, Joung JY, Seo HK, Lee KH, Chung J. A Case Report of Partial Nephrectomy of Mucinous Cystadenocarcinoma in Kidney and Its Literature Review. Cancer Res Treat 2015; 48:838-42. [PMID: 25687861 PMCID: PMC4843737 DOI: 10.4143/crt.2014.219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 10/27/2014] [Indexed: 11/26/2022] Open
Abstract
Mucinous cystadenocarcinoma (MC) of the kidney is a rare epithelial tumor originating from the renal pelvic urothelium and few study cases have been reported. Because of the rarity of these tumors and their unknown histogenesis, its diagnosis is difficult until surgical exploration. We report here on a 55-year-old man referred to the urology department from the hepatology department because of a cystic renal mass measuring approximately 5 cm in size, which was detected incidentally under ultrasonography during the routine examination of liver. The renal mass was finally diagnosed as MC originating from kidney after partial nephrectomy and the patient still showed no evidence of recurrence until 12 months postoperatively. This is the first report on a case of renal MC in a patient who underwent partial nephrectomy. The aim of this report is to present our unusual case of MC and also review the previous literature on the pathological and radiological aspects of MC of kidney.
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Affiliation(s)
- Sung Han Kim
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Heong Dong Yuk
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Weon Seo Park
- Department of Pathology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Sun Ho Kim
- Department of Radiology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Jae Young Joung
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Ho Kyung Seo
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Kang Hyun Lee
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Jinsoo Chung
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
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20
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Lin DL, Hu JL, Shao SH, Sun DM, Wang JG. Primary mucinous cystadenocarcinoma of the breast with endocervical-like mucinous epithelium. Breast Care (Basel) 2014; 8:445-7. [PMID: 24550753 DOI: 10.1159/000357657] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Primary mucinous cystadenocarcinoma of the breast is an extremely rare entity. To the best of our knowledge, only 17 patients have been described in the PubMed database. CASE REPORT Here, we report a primary breast mucinous cystadenocarcinoma with endocervical-like mucinous epithelium in a 62-year-old woman. The patient was followed for 5 months without any adjuvant treatment and she continues to be disease free. CONCLUSIONS Primary breast mucinous cystadenocarcinoma usually displays unique pathologic and immunohistochemical characteristics simulating its ovarian counterparts; it seems to have a good prognosis after complete resection.
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Affiliation(s)
- Dong-Liang Lin
- Department of Pathology, The Affiliated Hospital of Medical College, Qingdao University, China
| | - Ji-Lin Hu
- Department of General Surgery, The Affiliated Hospital of Medical College, Qingdao University, China
| | - Shi-Hong Shao
- Department of Pathology, The Affiliated Hospital of Medical College, Qingdao University, China
| | - Dong-Mei Sun
- Department of Ultrasonography, The Affiliated Hospital of Medical College, Qingdao University, China
| | - Ji-Gang Wang
- Department of Pathology, The Affiliated Hospital of Medical College, Qingdao University, China ; Department of Pathology, Shanghai Medical College, Fudan University, China
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21
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Kim SE, Park JH, Hong S, Koo JS, Jeong J, Jung WH. Primary Mucinous Cystadenocarcinoma of the Breast: Cytologic Finding and Expression of MUC5 Are Different from Mucinous Carcinoma. Korean J Pathol 2012; 46:611-6. [PMID: 23323116 PMCID: PMC3540343 DOI: 10.4132/koreanjpathol.2012.46.6.611] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 07/02/2012] [Accepted: 07/17/2012] [Indexed: 11/17/2022]
Abstract
Mucinous cystadenocarcinoma (MCA) in the breast is a rare neoplasm. There have been 13 cases of primary breast MCA reported. The MCA presents as a large, partially cystic mass in postmenopausal woman with a good prognosis. The microscopic findings resemble those of ovarian, pancreatic, or appendiceal MCA. The aspiration findings showed mucin-containing cell clusters in the background of mucin and necrotic material. The cell clusters had intracytoplasmic mucin displacing atypical nuclei to the periphery. Histologically, the tumor revealed an abundant mucin pool with small floating clusters of mucin-containing tumor cells. There were also small cysts lined by a single layer of tall columnar mucinous cells, resembling those of the uterine endocervix. The cancer cells were positive for mucin (MUC) 5 and negative for MUC2 and MUC6. This mucin profile is different from ordinary mucinous carcinoma and may be a unique characteristic of breast MCA.
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Affiliation(s)
- Sung Eun Kim
- Department of Pathology, Gangnam Sevrance Hsopital, Yonsei University College of Medicine, Seoul, Korea
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22
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Abstract
Appendiceal mucoceles are rare cystic lesions with an incidence of 0.3–0.7% of all appendectomies. They are divided into four subgroups according to their histology. Even though the symptoms may vary – depending on the level of complication – from right lower quadrant pain, signs of intussusception, gastrointestinal bleeding to an acute abdomen with sepsis, most mucoceles are asymptomatic and found incidentally. We present the case of a 70-year-old patient with an incidentally found appendiceal mucocele. He was seen at the hospital for backache. The CT scan showed a vertebral fracture and a 7-cm appendiceal mass. A preoperative colonoscopy displayed several synchronous adenomas in the transverse and left colon with high-grade dysplasia. In order to lower the cancer risk of this patient, we performed a subtotal colectomy. The appendiceal mass showed no histopathological evidence of malignancy and no sign of perforation. The follow-up was therefore limited to 2 months. In this case, appendectomy would have been sufficient to treat the mucocele alone. The synchronous high-grade dysplastic adenomas were detected in the preoperative colonoscopy and determined the therapeutic approach. Generally, in the presence of positive lymph nodes, a right colectomy is the treatment of choice. In the histological presence of mucinous peritoneal carcinomatosis, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is indicated. In conclusion, mucoceles of the appendix are detected with high sensitivity by CT scan. If there is no evidence of synchronous tumor preoperatively and no peritoneal spillage, invasion or positive sentinel lymph nodes during surgery, a mucocele is adequately treated by appendectomy.
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Affiliation(s)
- C Kim-Fuchs
- Department of Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland
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23
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Kim JH, Lee TS, Oh HK, Choi YS. A case of mucinous adenocarcinoma arising from retroperitoneal teratoma treated with chemoradiation. J Gynecol Oncol 2009; 20:126-8. [PMID: 19590726 DOI: 10.3802/jgo.2009.20.2.126] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Revised: 11/10/2008] [Accepted: 11/18/2008] [Indexed: 11/30/2022] Open
Abstract
Retroperitoneal teratoma with malignant transformation is a rare condition in adults. Its most common malignant transformation is into a squamous cell carcinoma, but rarely into a mucinous adenocarcinoma. Postoperative treatment of mucinous adenocarcinoma arising from teratomas has not been established due to its rare incidence. Here we present a case of retroperitoneal mucinous adenocarcinoma arising from a teratoma in the presacral area. Operative and postoperative managements are described with a brief review of the literatures.
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Affiliation(s)
- Ju Hyun Kim
- Department of Obstetrics and Gynecology, School of Medicine, Catholic University of Daegu, Daegu, Korea
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24
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Park JH, Whang SO, Song ES, Choi SJ, Lee WY. An ovarian mucinous cystadenocarcinoma arising from mature cystic teratoma with para-aortic lymph node metastasis: a case report. J Gynecol Oncol 2008; 19:275-8. [PMID: 19471656 DOI: 10.3802/jgo.2008.19.4.275] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Revised: 11/17/2008] [Accepted: 11/18/2008] [Indexed: 12/13/2022] Open
Abstract
Malignant transformation of a mature cystic teratoma (MCT) is an uncommon complication. The most common form of malignant transformation of a MCT is squamous cell carcinoma, representing 75% of malignant transformations. The frequency of malignant transformation of MCT to adenocarcinoma is just 6.8%. To the best of our knowledge, no case of para-aortic lymph node metastasis in mucinous adenocarcinoma arising from MCT has been reported before. The prognosis of malignant transformation of the MCT is very poor. Here, we report an unusual case of a 41-year-old woman with mucinous adenocarcinoma arising from MCT with para-aortic lymph node metastasis.
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Affiliation(s)
- Jee Hyun Park
- Department of Obstetrics and Gynecology, College of Medicine, Inha University, Incheon, Korea
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