Mucinous cystadenocarcinoma differential diagnosis

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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]

  • Asymptomatic
  • Epigastric fullness
  • Abdominal mass
  • Nausea and vomiting
  • Back pain
  • Solitary, multilocular or unilocular cysts with a fibrotic wall and containing mucin.
  • Columnar epithelium lined mucin-producing cysts with different level of dysplasia.
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.

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