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[[Mucinous cystadenocarcinoma risk factors|Common risk factors]] in the development of [[mucinous cystadenocarcinoma]] are [[obesity]] and post [[menopausal]] women on [[hormone replacement therapy]].
[[Mucinous cystadenocarcinoma risk factors|Common risk factors]] in the development of [[mucinous cystadenocarcinoma]] are [[obesity]] and post [[menopausal]] women on [[hormone replacement therapy]].
==Natural history, Complications and Prognosis==
==Natural history, Complications and Prognosis==
If left untreated, most of the patients with [[Mucinous cystadenocarcinoma natural history|mucinous cystadenocarcinomas]] may be confined to the [[Organ (biology)|organ]] itself. Common [[Mucinous cystadenocarcinoma natural history|complications of mucinous cystadenocarcinoma]] include [[metastasis]] and [[inguinal hernia]]. The presence of [[metastasis]] is associated with a particularly [[Prognosis|poor prognosis]] among patients with [[mucinous cystadenocarcinoma]].
If left untreated, most of the patients with [[Mucinous cystadenocarcinoma natural history|mucinous cystadenocarcinomas]] may be confined to the [[Organ (biology)|organ]] itself. Common [[Mucinous cystadenocarcinoma natural history|complications of mucinous cystadenocarcinoma]] include [[metastasis]] and [[inguinal hernia]]. The presence of [[metastasis]] is associated with a particularly [[Prognosis|poor prognosis]] among [[patients]] with [[mucinous cystadenocarcinoma]].
==Staging==
==Staging==
According to the [[American Joint Committee on Cancer|American Joint Committee on Cancer (AJCC)]], there are [[Mucinous cystadenocarcinoma staging|4 stages of mucinous cystadenocarcinoma]] based on the [[Mucinous cystadenocarcinoma physical examination|clinical features]] and [[Mucinous cystadenocarcinoma MRI|findings on imaging]]. Each stage is assigned a letter and a number that designate the [[tumor]] size, number of involved [[lymph node]] regions, and [[metastasis]].
According to the [[American Joint Committee on Cancer|American Joint Committee on Cancer (AJCC)]], there are [[Mucinous cystadenocarcinoma staging|4 stages of mucinous cystadenocarcinoma]] based on the [[Mucinous cystadenocarcinoma physical examination|clinical features]] and [[Mucinous cystadenocarcinoma MRI|findings on imaging]]. Each stage is assigned a letter and a number that designate the [[tumor]] size, number of involved [[lymph node]] regions, and [[metastasis]].
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[[Mucinous cystadenocarcinoma history and symptoms|Symptoms of mucinous cystadenocarcinoma]] of [[ovary]] include [[mass]] in the [[abdomen]], increase in [[abdominal]] size, [[bloating]], [[weight loss]], [[shortness of breath]], and [[pain]] [[abdomen]].
[[Mucinous cystadenocarcinoma history and symptoms|Symptoms of mucinous cystadenocarcinoma]] of [[ovary]] include [[mass]] in the [[abdomen]], increase in [[abdominal]] size, [[bloating]], [[weight loss]], [[shortness of breath]], and [[pain]] [[abdomen]].
==Physical Examination==
==Physical Examination==
Patients with mucinous cystadenocarcinoma usually appear normal. Physical examination of patients with mucinous cystadenocarcinoma is usually remarkable for abdominal distention, shifting dullness, a palpable abdominal mass, and coarse crackles upon auscultation of the lung bases.
[[Patients]] with [[Mucinous cystadenocarcinoma physical examination|mucinous cystadenocarcinoma]] usually appear normal. [[Physical examination]] of [[Mucinous cystadenocarcinoma physical examination|patients with mucinous cystadenocarcinoma]] is usually remarkable for [[abdominal distention]], [[shifting dullness]], a [[Abdominal mass|palpable abdominal mass]], and [[Crackles|coarse crackles]] upon [[auscultation]] of the [[Lung|lung bases]].
==CT==
==CT==
Findings on CT suggestive of mucinous cystadenocarcinoma include rounded or ovoid tumor, internal septations, and [[calcification]].
Findings on [[Computed tomography|CT]] suggestive of [[Mucinous cystadenocarcinoma CT|mucinous cystadenocarcinoma]] include rounded or [[Ovoid|ovoid tumor]], internal septations, and [[calcification]].
==MRI==
==MRI==
Findings on MRI suggestive of mucinous cystadenocarcinoma include lower signal intensity for loculi with watery mucin on T1-weighted images.
Findings on [[Magnetic resonance imaging|MRI]] suggestive of [[Mucinous cystadenocarcinoma MRI|mucinous cystadenocarcinoma]] include [[Magnetic resonance imaging|lower signal intensity for loculi]] with watery [[mucin]] on T1-weighted images.
==Ultrasound==
==Ultrasound==
[[Ultrasound]] may be helpful in the diagnosis of mucinous cystadenocarcinoma. Findings on ultrasound suggestive of mucinous cystadenocarcinoma include mural thickening and solid components.
[[Ultrasound]] may be helpful in the [[diagnosis]] of [[Mucinous cystadenocarcinoma echocardiography or ultrasound|mucinous cystadenocarcinoma]]. Findings on [[ultrasound]] [[Mucinous cystadenocarcinoma echocardiography or ultrasound|suggestive of mucinous cystadenocarcinoma include mural thickening and solid components]].
==Biopsy==
==Biopsy==
On microscopic histopathological analysis, mucinous differentiation, nuclear atypia, and necrosis are characteristic findings of mucinous adenocarcinoma.
On [[microscopic]] [[Histopathology|histopathological analysis]], [[Mucinous cystadenocarcinoma biopsy|mucinous differentiation, nuclear atypia, and necrosis are characteristic findings]] of [[mucinous cystadenocarcinoma]].
==Medical Therapy==
==Medical Therapy==
The main mode of treatment of mucinous cystadenocarcinoma is [[chemotherapy]] and [[radiation]].
The main mode of [[Mucinous cystadenocarcinoma medical therapy|treatment of mucinous cystadenocarcinoma]] is [[chemotherapy]] and [[radiation]].
==Surgery==
==Surgery==
The most effective treatment for mucinous cystadenocarcinoma is surgical resection.
The most effective [[Mucinous cystadenocarcinoma surgery|treatment for mucinous cystadenocarcinoma]] is [[surgical resection]].
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 16:06, 19 April 2019

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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 of the renal pelvis was first described in 1960 by Hasebe et al. Mucinous cystadenocarcinoma is one of the most aggressive forms of cancer. KRAS mutations are found in mucinous carcinomas. The organs involved in pathogenesis of mucinous cystadenocarcinoma are ovary, appendix, pancreas, colon, rectum, retroperitoneal organs, testes, salivary gland, lung, bladder, and breast. On gross pathology, multiloculated, smooth grey surface, and multilocular mass with thin walls and mucinous material are characteristic findings of mucinous cystadenocarcinoma. On microscopic histopathological analysis, mucinous differentiation, nuclear atypia, and necrosis are characteristic findings of mucinous cystadenocarcinoma. Mucinous cystadenocarcinoma commonly affects individuals older than forty years of age. Females are more commonly affected with mucinous cystadenocarcinoma of pancreas than males. Common risk factors in the development of mucinous cystadenocarcinoma are obesity and post-menopausal women on hormone replacement therapy. According to the American Joint Committee on Cancer (AJCC), there are 4 stages of mucinous cystadenocarcinoma based on the clinical features and findings on imaging. Each stage is assigned a letter and a number that designate the tumor size, number of involved lymph node regions, and metastasis. Findings on CT suggestive of mucinous cystadenocarcinoma include rounded or ovoid tumor, internal septations, and calcification. The main mode of treatment of mucinous cystadenocarcinoma is chemotherapy and radiation. The most effective treatment for mucinous cystadenocarcinoma is surgical resection.

Historical Perspective

Mucinous adenocarcinoma of the renal pelvis was first described in 1960 by Hasebe et al.[1]

Pathophysiology

Mucinous adenocarcinoma is one of the most aggressive forms of cancer. KRAS mutations are found in mucinous cystadenocarcinomas. The organs involved in pathogenesis of mucinous cystadenoma are ovary, appendix, pancreas, colon, rectum, retroperitoneal organs, testes, salivary gland, lung, bladder, and breast. On gross pathology, multiloculated, smooth grey surface, and multilocular mass with thin walls and mucinous material are characteristic findings of mucinous adenocarcinoma. On microscopic histopathological analysis, mucinous differentiation, nuclear atypia, and necrosis are characteristic findings of mucinous adenocarcinoma.

Causes

Mutations in the KRAS gene cause mucinous cystadenocarcinoma.

Differentiating Mucinous Cystadenocarcinoma from other Diseases

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

Epidemiology and Demographics

Mucinous cystadenocarcinoma commonly affects individuals older than forty years of age. Females are more commonly affected with mucinous cystadenocarcinoma of pancreas than males.

Risk Factors

Common risk factors in the development of mucinous cystadenocarcinoma are obesity and post menopausal women on hormone replacement therapy.

Natural history, Complications and Prognosis

If left untreated, most of the patients with mucinous cystadenocarcinomas may be confined to the organ itself. Common complications of mucinous cystadenocarcinoma include metastasis and inguinal hernia. The presence of metastasis is associated with a particularly poor prognosis among patients with mucinous cystadenocarcinoma.

Staging

According to the American Joint Committee on Cancer (AJCC), there are 4 stages of mucinous cystadenocarcinoma based on the clinical features and findings on imaging. Each stage is assigned a letter and a number that designate the tumor size, number of involved lymph node regions, and metastasis.

History and Symptoms

Symptoms of mucinous cystadenocarcinoma of ovary include mass in the abdomen, increase in abdominal size, bloating, weight loss, shortness of breath, and pain abdomen.

Physical Examination

Patients with mucinous cystadenocarcinoma usually appear normal. Physical examination of patients with mucinous cystadenocarcinoma is usually remarkable for abdominal distention, shifting dullness, a palpable abdominal mass, and coarse crackles upon auscultation of the lung bases.

CT

Findings on CT suggestive of mucinous cystadenocarcinoma include rounded or ovoid tumor, internal septations, and calcification.

MRI

Findings on MRI suggestive of mucinous cystadenocarcinoma include lower signal intensity for loculi with watery mucin on T1-weighted images.

Ultrasound

Ultrasound may be helpful in the diagnosis of mucinous cystadenocarcinoma. Findings on ultrasound suggestive of mucinous cystadenocarcinoma include mural thickening and solid components.

Biopsy

On microscopic histopathological analysis, mucinous differentiation, nuclear atypia, and necrosis are characteristic findings of mucinous cystadenocarcinoma.

Medical Therapy

The main mode of treatment of mucinous cystadenocarcinoma is chemotherapy and radiation.

Surgery

The most effective treatment for mucinous cystadenocarcinoma is surgical resection.

References

  1. HASEBE M, SERIZAWA S, CHINO S (1960). "[On a case of papillary cystadenocarcinoma following malignant degeneration of a papillary adenoma in the kidney pelvis]". Yokohama Med Bull. 11: 491–500. PMID 13712095.

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