Mucinous cystadenocarcinoma differential diagnosis: Difference between revisions

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cystadenoma  
cystadenoma  


of pancreas<ref name="pmid17903202">{{cite journal |vauthors=Campbell F, Azadeh B |title=Cystic neoplasms of the exocrine pancreas |journal=Histopathology |volume=52 |issue=5 |pages=539–51 |date=April 2008 |pmid=17903202 |doi=10.1111/j.1365-2559.2007.02856.x |url=}}</ref><ref name="pmid18497542">{{cite journal |vauthors=Garcea G, Ong SL, Rajesh A, Neal CP, Pollard CA, Berry DP, Dennison AR |title=Cystic lesions of the pancreas. A diagnostic and management dilemma |journal=Pancreatology |volume=8 |issue=3 |pages=236–51 |date=2008 |pmid=18497542 |doi=10.1159/000134279 |url=}}</ref><ref name="pmid10674612">{{cite journal |vauthors=Sarr MG, Carpenter HA, Prabhakar LP, Orchard TF, Hughes S, van Heerden JA, DiMagno EP |title=Clinical and pathologic correlation of 84 mucinous cystic neoplasms of the pancreas: can one reliably differentiate benign from malignant (or premalignant) neoplasms? |journal=Ann. Surg. |volume=231 |issue=2 |pages=205–12 |date=February 2000 |pmid=10674612 |pmc=1420988 |doi= |url=}}</ref><ref name="pmid10199470">{{cite journal |vauthors=Zamboni G, Scarpa A, Bogina G, Iacono C, Bassi C, Talamini G, Sessa F, Capella C, Solcia E, Rickaert F, Mariuzzi GM, Klöppel G |title=Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors |journal=Am. J. Surg. Pathol. |volume=23 |issue=4 |pages=410–22 |date=April 1999 |pmid=10199470 |doi= |url=}}</ref>
of pancreas<ref name="pmid17903202">{{cite journal |vauthors=Campbell F, Azadeh B |title=Cystic neoplasms of the exocrine pancreas |journal=Histopathology |volume=52 |issue=5 |pages=539–51 |date=April 2008 |pmid=17903202 |doi=10.1111/j.1365-2559.2007.02856.x |url=}}</ref><ref name="pmid18497542">{{cite journal |vauthors=Garcea G, Ong SL, Rajesh A, Neal CP, Pollard CA, Berry DP, Dennison AR |title=Cystic lesions of the pancreas. A diagnostic and management dilemma |journal=Pancreatology |volume=8 |issue=3 |pages=236–51 |date=2008 |pmid=18497542 |doi=10.1159/000134279 |url=}}</ref><ref name="pmid10674612">{{cite journal |vauthors=Sarr MG, Carpenter HA, Prabhakar LP, Orchard TF, Hughes S, van Heerden JA, DiMagno EP |title=Clinical and pathologic correlation of 84 mucinous cystic neoplasms of the pancreas: can one reliably differentiate benign from malignant (or premalignant) neoplasms? |journal=Ann. Surg. |volume=231 |issue=2 |pages=205–12 |date=February 2000 |pmid=10674612 |pmc=1420988 |doi= |url=}}</ref><ref name="pmid10199470">{{cite journal |vauthors=Zamboni G, Scarpa A, Bogina G, Iacono C, Bassi C, Talamini G, Sessa F, Capella C, Solcia E, Rickaert F, Mariuzzi GM, Klöppel G |title=Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors |journal=Am. J. Surg. Pathol. |volume=23 |issue=4 |pages=410–22 |date=April 1999 |pmid=10199470 |doi= |url=}}</ref><ref name="pmid21128317">{{cite journal |vauthors=Testini M, Gurrado A, Lissidini G, Venezia P, Greco L, Piccinni G |title=Management of mucinous cystic neoplasms of the pancreas |journal=World J. Gastroenterol. |volume=16 |issue=45 |pages=5682–92 |date=December 2010 |pmid=21128317 |pmc=2997983 |doi= |url=}}</ref>
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* Asymptomatic
* Asymptomatic
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* Back pain  
* Back pain  
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* Epigastric mass
* Abdominal fullness
* Ascities
* Pallor
* Lymphadenopathy
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* CEA
* CA 19-9
* Hb
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* EUS for evaluation of the cyst wall, may show nodules within the cyst
* To obtain aspiration of the cyst material
* To perform biopsy
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* CT is important for differentiating MCN from other tumors
* Shape is smooth
* Main pancreatic duct is not dilated
*
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* MRI cross-sectional images may show unilocular or multilocular cyst with a solid component
* peripheral calcification
* wall thickening
* Papillary structures
* Hypervascular pattern
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| style="background: #F5F5F5; padding: 5px;" |
* Solitary, multilocular or unilocular cysts with a fibrotic wall and containing mucin.
* Solitary, multilocular or unilocular cysts with a fibrotic wall and containing mucin
* Columnar epithelium lined mucin-producing cysts with different level of dysplasia.
* Columnar epithelium lined mucin-producing cysts with different level of dysplasia
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| style="background: #F5F5F5; padding: 5px;" |Biopsy and histopathology
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pancreatic pseudocyst|Pancreatic]]  
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pancreatic pseudocyst|Pancreatic]]  

Revision as of 14:56, 12 April 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Overview

Mucinous cystadenocarcinoma must be differentiated from mucinous cystadenoma, serous cystadenoma, and pseudocyst.

Differentiating Mucinous cystadenocarcinoma from other Diseases

Mucinous cystadenocarcinoma of ovary

  • Mucinous borderline tumor of the ovary
  • Metastatic mucinous carcinoma[1]

Mucinous cystadenocarcinoma of pancreas

Mucinous cystadenocarcinoma of appendix

  • Appendicitis
  • Nonmucinous appendiceal tumors
  • Mesenteric cyst[2][3]
Mucinous

cystadenocarcinoma

of ovary

Clinical manifestations Para-clinical findings Gold standard
Sign and symptoms Physical

examination

Lab Findings Imaging Histopathology
US CT MRI
Mucinous

borderline

tumor

of the ovary

  • Asymptomatic initially
  • Vaginal bleeding
  • Abdominal mass
  • Increased abdominal girth
  • Abdominal mass
  • Decreased Hb
  • Raised CEA
  • Localizes tumor
  • Demarcates the cancer
  • To visulaize the extent of the tumor
  • Large multiloculated cystic masses
  • mucus-containing cysts
  • Image guided biopsy and histopathological analysis
Metastatic

mucinous

carcinoma[4]

  • Ascities
  • Abdominal mass
  • Abdominal fullness
  • Early satiety
  • Fatigue
  • Bowel obstruction
  • Pleural effusion
  • Pelvic or abdominal pain
  • Venous thromboembolism
  • Bloating
  • Urinary frequency
  • Increased abdominal girth
  • Abdominal mass
  • Ascities
  • Pallor
  • Lymphadenopathy
  • Incresed CA-125
  • Decreased-Hb
  • Raised CEA
  • For the assessment for ascites and to the extent of cancer
  • Shows intra-abdominal spread
  • Shows distant metastasis and extent of the tumor
  • Mucinous differentiation
  • Tall columnar cells with apical mucin
  • Endocervical or intestinal-like appearance
  • Back-to-back cribriform glands with confluent growth pattern
  • Invasive morphology
  • Image-guided biopsy of patients with peritoneal metastasis and histopathological analysis
Mucinous

cystadenocarcinoma of pancreas

Symptoms Physical examination Lab Findings US CT MRI Histopathology Gold standard
Mucinous

cystadenoma

of pancreas[5][6][7][8][9]

  • Asymptomatic
  • Epigastric fullness
  • Abdominal mass
  • Nausea and vomiting
  • Back pain
  • Epigastric mass
  • Abdominal fullness
  • Ascities
  • Pallor
  • Lymphadenopathy
  • CEA
  • CA 19-9
  • Hb
  • EUS for evaluation of the cyst wall, may show nodules within the cyst
  • To obtain aspiration of the cyst material
  • To perform biopsy
  • CT is important for differentiating MCN from other tumors
  • Shape is smooth
  • Main pancreatic duct is not dilated
  • MRI cross-sectional images may show unilocular or multilocular cyst with a solid component
  • peripheral calcification
  • wall thickening
  • Papillary structures
  • Hypervascular pattern
  • Solitary, multilocular or unilocular cysts with a fibrotic wall and containing mucin
  • Columnar epithelium lined mucin-producing cysts with different level of dysplasia
 Biopsy and histopathology
Pancreatic

pseudocyst

Serous

cystadenoma

of pancreas

Mucinous

cystadenocarcinoma of appendix

Symptoms Physical examination Lab 1 US CT MRI Histopathology Gold standard
Appendicitis
Nonmucinous

appendiceal

tumors

Mesenteric

cyst[2]

References

  1. ↑ Ovary Epithelial tumors. Atlasgeneticsoncology (2016).http://atlasgeneticsoncology.org/Tumors/OvaryEpithTumID5230.html Accessed on February 29, 2016
  2. ↑ 2.0 2.1 Hamilton DL, Stormont JM (1989). "The volcano sign of appendiceal mucocele". Gastrointest. Endosc. 35 (5): 453–6. PMID 2792684.
  3. ↑ Raijman I, Leong S, Hassaram S, Marcon NE (March 1994). "Appendiceal mucocele: endoscopic appearance". Endoscopy. 26 (3): 326–8. doi:10.1055/s-2007-1008979. PMID 8076556.
  4. ↑ Hewitt MJ, Anderson K, Hall GD, Weston M, Hutson R, Wilkinson N, Perren TJ, Lane G, Spencer JA (January 2007). "Women with peritoneal carcinomatosis of unknown origin: Efficacy of image-guided biopsy to determine site-specific diagnosis". BJOG. 114 (1): 46–50. doi:10.1111/j.1471-0528.2006.01176.x. PMID 17233859.
  5. ↑ Campbell F, Azadeh B (April 2008). "Cystic neoplasms of the exocrine pancreas". Histopathology. 52 (5): 539–51. doi:10.1111/j.1365-2559.2007.02856.x. PMID 17903202.
  6. ↑ Garcea G, Ong SL, Rajesh A, Neal CP, Pollard CA, Berry DP, Dennison AR (2008). "Cystic lesions of the pancreas. A diagnostic and management dilemma". Pancreatology. 8 (3): 236–51. doi:10.1159/000134279. PMID 18497542.
  7. ↑ Sarr MG, Carpenter HA, Prabhakar LP, Orchard TF, Hughes S, van Heerden JA, DiMagno EP (February 2000). "Clinical and pathologic correlation of 84 mucinous cystic neoplasms of the pancreas: can one reliably differentiate benign from malignant (or premalignant) neoplasms?". Ann. Surg. 231 (2): 205–12. PMC 1420988. PMID 10674612.
  8. ↑ Zamboni G, Scarpa A, Bogina G, Iacono C, Bassi C, Talamini G, Sessa F, Capella C, Solcia E, Rickaert F, Mariuzzi GM, Klöppel G (April 1999). "Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors". Am. J. Surg. Pathol. 23 (4): 410–22. PMID 10199470.
  9. ↑ Testini M, Gurrado A, Lissidini G, Venezia P, Greco L, Piccinni G (December 2010). "Management of mucinous cystic neoplasms of the pancreas". World J. Gastroenterol. 16 (45): 5682–92. PMC 2997983. PMID 21128317.

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