| Print Date: | May 19, 2013, 8:07 pm |
| Title | Mucinous Cystic Neoplasm of the Pancreas |
| Text | Mucinous Csytic Neoplasm of the Pancreas; AKA-macrocystic adenoma, mucinous cystadenoma, cystadenocarcinoma.
Frequency- 10% of pancreatic cysts, 1% of pancreatic neoplasms Mean Age- 50 years ( 20-95 ), 50% between 40-60 years old M:F 1:19 Pathology: Large smooth round/lobulated multiloculated cystic mass encapsulated by a layer of fibrous connective tissue Histology: similar to biliary and ovarian mucinous tumors; cysts lined by tall columnar, mucin-producing cells subtended by a densely cellular mesenchymal stroma (reminiscent of ovarian stroma), often in papillary arrangement Location: often in the tail (90%), body, infrequently in head -well-demarcated thick-walled mass, mean 10-12 cm -multi/unilocular large cyss >2 cm with thin septa <2 mm * a tumor with <6 cysts of >2 cm in diameter is in 93-95% a mucinous cystic neoplasm -amorphous discontinuous peripheral mural calcifications (10-15%) -solid papillary excresences protrude into the interior of the tumor -hypovascular mass with sparse neovascularity -great propensity for invasion of adjacent organs U/S: -cysts may contain low level echoes; echogenic mural calcifications if present CT: -internal septations may not be seen without contrast enhancement; cysts with HU of water, different cysts with different HU's; enhance of cyst walls MRI: -high T2 from mucinous component Angio: -predominantly avascular mass, small area of blush in cyst wall and solid components, mass effect on adjacent arteries and veins by cysts Mets: -round thick walled cystic lesions in the liver Prognosis: -invariable transformation into cystadenocarcinoma Rx: -complete surgical excision, 5 yr survival is 74-90% DDx: pseudocyst, lymphangioma/hemangioma, variants of ductal adenocarcinoma, solid and cystic papillary epithelioid neoplasm, cystic islet cell tumor, cystic met, atypical serous cystadenoma, sarcoma, infection (amebiasis, echinococcus0 |
| References: | Radiology Review Manual, Dahnert, W., MD, 4th Edition, Lippincott, Williams and Wilkins, Philadelphia.
Magnetic Resonance Imaging, Stark, D., and Bradley, W., 3rd Edition, |
| Contributor | Andrew E Simays, MD (Naval Medical Center San Diego) |
| Peer Reviewer | James G. Smirniotopoulos, M.D. (Uniformed Services University) |
| Record Number | : 1576 |
| Created | 2001-03-29 19:25:04-05 |
| Modified | 2004-06-10 23:24:22-04 |
| Category: | Neoplasm, malignant (NOS) |
| Location: | Gastrointestinal |
| Sublocation: | Pancreas |
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