Pancreatic mucinous cystic neoplasm
Encyclopedia
Pancreatic mucinous cystic neoplasm, also mucinous cystic neoplasm of the pancreas and mucinous cystic tumour, is a grouping of cystic
neoplasms that arise from the pancreas
. They may be benign, malignant or in between.
The prognosis of this set of tumours is highly variable and dependent on the specific sub-classification (benign, borderline, malignant).
(WHO) as cystic epithelial neoplasms that occur almost exclusively in women; do not communicate with the pancreatic ductal system and which are composed of columnar, mucin-producing epithelium, supported by ovarian-type stroma. This mouthful simply means that these tumors make mucin (a thick sticky fluid), they do not arise in the larger pancreatic ducts, and they have a peculiar supporting stroma (or support structure).
including good clinical history
, state of the art
imaging, and careful pathology is often needed to establish the correct diagnosis .
Some mucinous cystic neoplasms are confined to the tumor. These are designated using various names including “mucinous cystic neoplasm with low-grade dysplasia,” “mucinous cystic neoplasm with moderate dysplasia,” “borderline mucinous cystic neoplasm,” and “mucinous cystic neoplasm with high-grade dysplasia.” These are all curable when completely removed surgically. About a third of mucinous cystic neoplasms have progressed or “degenerated” into an invasive cancer. These are designated either “mucinous cystadenocarcinoma” or “mucinous cystic neoplasm with an associated invasive carcinoma.” These latter lesions have the potential to spread (metastasize) to other organs.
Cyst
A cyst is a closed sac, having a distinct membrane and division on the nearby tissue. It may contain air, fluids, or semi-solid material. A collection of pus is called an abscess, not a cyst. Once formed, a cyst could go away on its own or may have to be removed through surgery.- Locations :* Acne...
neoplasms that arise from the pancreas
Pancreas
The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...
. They may be benign, malignant or in between.
The prognosis of this set of tumours is highly variable and dependent on the specific sub-classification (benign, borderline, malignant).
Definition
Mucinous cystic neoplasms of the pancreas are defined by the World Health OrganizationWorld Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO) as cystic epithelial neoplasms that occur almost exclusively in women; do not communicate with the pancreatic ductal system and which are composed of columnar, mucin-producing epithelium, supported by ovarian-type stroma. This mouthful simply means that these tumors make mucin (a thick sticky fluid), they do not arise in the larger pancreatic ducts, and they have a peculiar supporting stroma (or support structure).
Classification
Mucinous cystic neoplasms of the pancreas classified as benign, borderline, or malignant, based on histomorphologic features which predict their behaviour.Symptoms
Most mucinous cystic neoplasms arise in women (95%) and these women are usually in their 40s or 50s. Clinically many mucinous cystic neoplasms are discovered as incidental findings during imaging for another indication. Larger mucinous cystic neoplasms can compress adjacent organs and lead to weight loss, or a sense of fullness. Really large mucinous cystic neoplasms can even be felt on physical examination. A multidisciplinary approachMultidisciplinary approach
A multidisciplinary approach to problem solving involves drawing appropriately from multiple disciplines to redefine problems outside of normal boundaries and reach solutions based on a new understanding of complex situations....
including good clinical history
Medical history
The medical history or anamnesis of a patient is information gained by a physician by asking specific questions, either of the patient or of other people who know the person and can give suitable information , with the aim of obtaining information useful in formulating a diagnosis and providing...
, state of the art
State of the art
The state of the art is the highest level of development, as of a device, technique, or scientific field, achieved at a particular time. It also refers to the level of development reached at any particular time as a result of the latest methodologies employed.- Origin :The earliest use of the term...
imaging, and careful pathology is often needed to establish the correct diagnosis .
Pathology
Resected mucinous cystic neoplasms have a characteristic appearance- they tend to be between 6 and 10 centimeters in size (2 to 5 inches), they contain numerous cysts (small cavities), and the cysts are filled with thick mucin (see the photograph). Under the microscope, the cysts are line by tall mucin-producing cells. These are the tumor cells. The tumor cells “sit” on ovarian-type stroma. This “ovarian-type stroma” is connective tissue that resembles some of the tissue normally found in the female ovary. .Some mucinous cystic neoplasms are confined to the tumor. These are designated using various names including “mucinous cystic neoplasm with low-grade dysplasia,” “mucinous cystic neoplasm with moderate dysplasia,” “borderline mucinous cystic neoplasm,” and “mucinous cystic neoplasm with high-grade dysplasia.” These are all curable when completely removed surgically. About a third of mucinous cystic neoplasms have progressed or “degenerated” into an invasive cancer. These are designated either “mucinous cystadenocarcinoma” or “mucinous cystic neoplasm with an associated invasive carcinoma.” These latter lesions have the potential to spread (metastasize) to other organs.
Treatment
A multi-disciplinary team approach, involving the coordinated efforts of clinicians, radiologists and pathologists is often the best way to evaluate a tumor involving the pancreas . In general, if the patient is healthy enough, the treatment of choice is surgical resection. Patients with an invasive cancer arising in association with a mucinous cystic neoplasm are often treated post-operatively with chemotherapy or radiation therapy.See also
- Solid pseudopapillary neoplasm
- Pancreatic serous cystadenomaPancreatic serous cystadenomaPancreatic serous cystadenoma, also known as serous cystadenoma of the pancreas and serous microcystic adenoma, a benign tumour of pancreas...
- Intraductal papillary mucinous neoplasmIntraductal papillary mucinous neoplasmIntraductal papillary mucinous neoplasm is a type of tumor that grows within the pancreatic ducts and is characterized by the production of thick fluid by the tumor cells...