Mucinous cystic neoplasm
Mucinous cystic neoplasm
Updated: 03/26/2019
© Jun Wang, MD, PhD
General features
- Benign or potentially low grade malignant
- Cystic epithelial neoplasm composed of mucin producing cells
- One of three precursor lesions of pancreatic adenocarcinoma
- Almost always women, mean age 45 years
- May be associated with invasive carcinoma
- Metastases usually restricted to abdominal cavity
- Need to differentiated from primary ovarian mucinous neoplasm if ovarian involved
Clinical presentations
- Abdominal pain, recurrent pancreatitis, gastric outlet obstruction, and/or mass
- Jaundice and/or weight loss if malignant
Key pathological features
- Usually in body/tail, multilocular (occasionally unilocular) megacysts
- No communication with ductal system unless fistula formed
- Cyst wall papillary, trabecular or thickened
- Mucoid/watery cyst contents
- Mucinous epithelium with dense “ovarian type” stroma
- Ovarian type stroma is ER+, PR+, inhibin+, CD10+
- May present with low- or intermediate-grade dysplasia, with high-grade dysplasia or with an associated invasive carcinoma
Molecular abnormalities
- Commonly harbor mutations of KRAS, p53 and RNF43
Treatment
- Surgery
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