Case Of Mucinous Cystadenoma Research Articles

Laparoscopic antegrade spleen-preserving distal pancreatectomy with conservation of the splenic vessels: a prospective multi-centre case series (with video)

Introduction: Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) with conservation of the splenic artery and vein (Kimura’ technique) is considered a technically challenging procedure that requires a high level of expertise in laparoscopic and pancreatic surgery. Methods: A prospective descriptive study on 18 patients with laparoscopic “antegrade” spleen-preserving distal pancreatectomy with Kimura’ technique from 2018 to 2023. The perioperative indications, clinical data, intraoperative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: The mean age was 39.4±13.3. Only 2 male patients accounted for 11.1%. The average operating time is 171±23 min. The average blood loss is 65.7±43 ml. The average tumor size is 4.1 cm. The average hospitalization is 9.4 days. The rate of pancreatic fistula is 66.7%. There is no case of transferring open surgery or blood transfusion during surgery. The results of pathological after surgery there were eight cases of solid pseudopapillary tumors, four cases of mucinous cystadenoma, six cases of neuroendocrine tumors. Conclusion: Kimura’s technique for laparoscopic spleen-preserving distal pancreatectomy is safe and feasible, which can be applied to benign tumors in the body and tail of the pancreas. However, this is a difficult technique in laparoscopic surgery that requires surgeons to have a lot of experience and equipment need to be adequate.

Clinicopathological Analysis of Adnexal Masses Presenting in a Tertiary Healthcare Centre, Karnataka, India: A Retrospective Observational Study

Introduction: The ovaries, fallopian tubes, and the broad ligament make up the anatomical adnexa. Adnexal masses represent a commonly occurring issue in gynaecology. The majority of ovarian malignancies are detected at advanced stages. The clinical manifestations of adnexal masses vary, with many cancers either showing no symptoms or presenting with vague signs. In the reproductive age group, the most typical manifestation is a benign functional cyst. Aim: To conduct a clinico-pathological analysis of adnexal masses among women presenting at a tertiary healthcare centre. Materials and Methods: A retrospective observational study was conducted in the Department of Obstetrics and Gynaecology at Akash Institute of Medical Science and Research Centre, Devanahalli, Karnataka, India, from November 2022 to April 2024. The diagnosis of adnexal mass was based on clinical symptoms, abdominal examination, bimanual examination, and trans-abdominal ultrasound. The CA-125 and other tumour markers were sent depending on the risk of malignancy. All tissues were sent for histopathological examination. The data were collected and tabulated in a Microsoft excel sheet, and percentages were calculated. Results: This study included 38 cases, in which benign ovarian and para-ovarian cysts were the most common findings, observed in 21 cases (55.3%). There were six cases of benign serous cystadenoma (15.8%), three cases of teratoma (7.9%), two cases of high-grade serous carcinoma (5.3%), one case of germ cell tumour (2.6%), one case of mucinous cystadenoma (2.6%), two cases of endometriotic cysts (5.3%), one case of adnexal cystic degeneration of a fibroid (2.6%), and one rare case of primary fallopian tube carcinoma (2.6%). The most common presenting complaint was abdominal pain, reported in 21 cases (55.3%). Conclusion: Adnexal masses can present in a variety of forms, ranging from benign cysts to infections and cancers. A thorough history and clinical examination are essential for accurate diagnosis. Investigations support the diagnosis, and histology confirms it.

Analysis of the clinical efficacy of laparoscopic middle pancreatectomy in the treatment of benign or low-grade malignant tumors of the pancreas.

The aim of this study was to investigate the clinical efficacy of laparoscopic middle pancreatectomy in the treatment of benign and junctional tumors of the pancreas. Retrospective analysis of basic data, tumor diameter, statistical analysis, and evaluation of efficacy-related indicators such as operative time, intraoperative bleeding, pathological findings, postoperative hospital stay, postoperative pancreatic fistula incidence, and pancreatic endocrine function was carried out on 17 patients diagnosed with benign or low-grade malignant tumors of the pancreas and laparoscopic middle pancreatic resection from January 2018 to January 2023 at the First Affiliated Hospital of Hunan Normal University. A total of 17 patients were screened. There were eight males and nine females; mean age was 42.8 ± 17.4 years (range: 15-69 years); BMI was 22.6 ± 2.5 kg/m2 (range: 18.4-27.5 kg/m2), and the tumor size was 3.4 ± 1.2cm (range: 1.5-5.5 cm). Preoperative glycan antigen CA19-9 was negative and CA125 was negative. Surgical time was 393.2 ± 57.9min; intraoperative bleeding was 211.7 ± 113.9ml; tumor diameter size was 3.4 ± 1.2cm; postoperative admission time was 19.4 ± 7.6 days; postoperative pancreatic fistula (POPF) grading was 17 cases, including nine cases of A-grade fistula, three cases of B-grade fistula, and none of C-grade fistula; postoperative pathology results were five cases of plasmacytoma, three cases of mucinous cystadenoma, four cases of SPN (solid pseudopapillary neoplasm), one case of Intraductal Papillary Mucinous Neoplasm (IPMN), three cases of pancreatic Neuroendocrine Neoplasm (pNEN), one case of inflammatory myofibroblastic osteoblastoma. All cases did not develop pancreatic origin diabetes or exacerbation of previous diabetes, and no cases presented symptoms of exocrine insufficiency such as dyspepsia and diarrhea. Laparoscopic middle pancreatectomy is safe and feasible in the treatment of benign or low-grade malignant tumors in the body of the pancreatic neck and is not accompanied by increased risk of intraoperative and postoperative complications and endocrine dysfunction of the pancreas.

A Case of Huge Mucinous Cystadenoma

Introduction: Ovarian mucinous cystadenoma is a benign tumour that arises from the surface epithelium of ovary. Aim/Objectives: To report the occurrence of a huge benign ovarian tumour. Case Report: A 24-year-old female presented to the OPD with complaints of pain lower abdomen, loss of appetite, and abdominal distension since 4 months. Her USG and CT scan reports showed it to be case of mucinous cystadenoma. She underwent laparotomy with left-sided cystectomy. Her Histopathological report showed borderline mucinous tumour. Peritoneal washing showed negative for atypical cells. Discussion: Giant tumours are now a rare presentation due to their early diagnosis due to routine check-ups on ultrasound

Histopathological study of ovarian tumors in a tertiary care center

Introduction: Ovary is a complex structure and its neoplasms show a wide spectrum of histological types and clinical behavior. The present study was done with the aim of studying the histopathological pattern of ovarian tumors in women of various age groups. Ovarian tumors represent about 30% of all cancers of the female genital system. Ovarian tumor is the seventh leading cause of cancer death. Ovarian tumors are often difficult to detect until they are advanced in stage or size, as symptoms are vague and insidious. An accurate and early diagnosis of malignant lesions will go a long way in the optimal management of these cases. Aims and Objectives: To determine the frequency of different histological types of ovarian tumors in a tertiary care center. Materials and Methods: This was a retrospective study included 150 cases of histopathologically proven ovarian tumors, reported in the Sree Mookambika Institute of medical sciences, over a one and half year period (January 2018 to June 2019). These were classified according to the WHO classification of ovarian tumors. Clinical presentation of the patients was analyzed from archived case records. Results: Of 150 cases of ovarian tumors, 138 masses were unilateral (92%) and 12 were bilateral (8%). Benign neoplastic lesions were 58.7%, and malignant was 2%.In benign neoplastic, the most common neoplasm was serous cystadenoma followed by mucinous cystadenoma In malignant, the current study had 2 cases of mucinous cystadenoma with borderline malignancy and 1 case was serous papillary cystadenocarcinoma Conclusion: A more detailed prospective study include genetic profiling, to establish the reason for this low incidence of malignant lesions

Prerectal mucinous cystadenoma. A case report and considerations about its origin

Mucinous cystadenoma is a generic denomination usually applied to cystic formations filled with mucinous content and showing signs of epithelial proliferation. They usually arise in ovaries, pancreas and appendix, but there have been occasional reports in many other locations. Most retroperitoneal and mesenteric mucinous cystadenomas have affected women, and a potential mullerian origin has been postulated, although for most of them their histogenesis remains uncertain. Some cases have shown malignant behavior. We herein describe a case of mucinous cystadenoma affecting a young man with an unusual prerectal location. An exhaustive study was performed as a basis for the discussion of possible origins for this tumor. This lesion showed premalignant proliferative changes, suggesting an early stage in a potential malignant transformation. DOI: 10.21276/APALM.1453

Surgical experience on Roux-en-Y pancreaticojejunostomy after local pancreatic head resection for benign tumors of the pancreatic head

To explore the value of Roux-en-Y pancreaticojejunostomy after local pancreatic head resection in treating benign tumors of pancreatic head (BTPH). The clinical data of 12 patients diagnosed as BTPH and treated by Roux-en-Y pancreaticojejunostomy after local pancreatic head resection in Department of General Surgery, Peking University Third Hospital from November 2006 to October 2013 were retrospectively analyzed.Of the 12 cases, 5 patients were male, 7 patients were female, the age of patients ranged from 21 to 64 years(average 42.3 years). Diameter of tumors was 3.0-4.8 cm.Diameter of pancreatic wound after resection was 5.1-7.9 cm, and main pancreatic duct injury happened in 1 case. Two cases of mucinous cystadenoma, 2 insulinoma, 3 solid pseudopapillary tumor and 4 nonfunctional pancreatic neuroendocrine tumors were confirmed histopathologically.No mortality and pancreatic leakage occurred during the perioperative period.All the 12 patients had no sign of recurrence.Experienced good life quality without occurrence of diabetes during the follow-up period of 24-108 months(more than 60 months in 4 cases). Roux-en-Y pancreaticojejunostomy after local pancreatic head resection is a reasonable choice for benign tumors of the pancreatic head as long as the patient is properly selected.

64-Slice spiral computed tomography and three-dimensional reconstruction in the diagnosis of cystic pancreatic tumors.

The present study aimed to describe the characteristics of cystic pancreatic tumors using computed tomography (CT) and to evaluate the diagnostic accuracy (DA) of post-imaging three-dimensional (3D) reconstruction. Clinical and imaging data, including multi-slice spiral CT scans, enhanced scans and multi-faceted reconstruction, from 30 patients with pathologically confirmed cystic pancreatic tumors diagnosed at the Linyi People's Hospital between August 2008 and June 2014 were retrospectively analyzed. Following the injection of Ultravist® 300 contrast agent, arterial, portal venous and parenchymal phase scans were obtained at 28, 60 and 150 sec, respectively, and 3D reconstructions of the CT images were generated. The average age of the patients was 38.4 years (range, 16-77 years), and the cohort included 5 males and 25 females (ratio, 1:5). The patients included 8 cases of mucinous cystadenoma (DA), 80%]; 9 cases of cystadenocarcinoma (DA, 84%); 6 cases of serous cystadenoma (DA, 100%); 3 cases of solid pseudopapillary tumor (DA, 100%); and 4 cases of intraductal papillary mucinous neoplasm (DA, 100%). 3D reconstructions of CT images were generated and, in the 4 cases of intraductal papillary mucinous neoplasm, the tumor was connected to the main pancreatic duct and multiple mural nodules were detected in one of these cases. The DA of the 3D-reconstructed images of cystic pancreatic tumors was 89.3%. The 64-slice spiral CT and 3D-reconstructed CT images facilitated the visualization of cystic pancreatic tumor characteristics, in particular the connections between the tumor and the main pancreatic duct. In conclusion, the 3D reconstruction of multi-slice CT data may provide an important source of information for the surgical team, in combination with the available clinical data.

Giant Ovarian Mucinous Cystadenoma in Premenarchal Girl

Ovarian cysts are an extremely common gynecological problem in adolescent. Ovarian Mucinous cystadenoma are rare in children. A 14-year-old presented with a history of increasing abdominal distension and pain for approximately six months. An adnexal mass measuring 24x18x13 cm was detected by abdominal ultrasonography and computed tomography. She underwent laparotomy and after surgical removal. Histopathology findings showed that the tumor was diagnosed as a mucinous cystadenoma(MCA) of the ovary. Epithelial tumors should not be forgotten in the differential diagnosis. We present a case of giant MCA of the right ovary in a 14-year-old pubertal girl and a review of the supporting literature.

Mucus Containing Cystic Lesions “Mucocele” of the Appendix: The Unresolved Issues

Background. Mucocele of the appendix is a rare condition, the pathological classification and management strategy of which have not been standardized yet. Aim. To report on our management of appendiceal mucocele, highlighting the pitfalls and possible means for avoiding them. Materials and Methods. Our registries were reviewed to retrieve cases of appendiceal mucocele, encountered in the period from July 2008 to May 2013. Results. We had 9 cases, three males and sex females, with a median age of 62 years. Abdominal ultrasound (US) and computerized axial tomography scan (CT) suspected the diagnosis in only one case each. Open appendectomy was done in two cases of mucinous cystadenoma with no further surgery performed, despite the positive margin in one. Laparoscopic appendectomy was done in three cases: mucinous cystadenoma in one case which needed no further surgery, mucinous cystadenocarcinoma with pseudomyxoma peritonei in another, and low grade mucinous tumour in a third case, and all needed subsequent right hemicolectomy. Exploratory laparotomy was done in three cases: of these, synchronous right hemicolectomy was done in one case of mucinous cystadenoma/?mucinous tumour of uncertain malignant potential; in the other two cases, appendectomy only was done for mucinous hyperplasia with carcinoid tumour of the appendix in one case and mucinous cystadenoma/?mucinous tumour of uncertain malignant potential in another. The 9th case was discovered upon laparoscopy for cholecystectomy; when pseudomyxoma peritonei arising from an appendiceal mucocele was found, laparoscopic appendectomy with peritoneal biopsy was then performed instead. Histopathologic diagnostic uncertainty was present in two cases of mucinous cystadenoma where mucinous tumour of uncertain malignant potential was an alternative possibility. Perioperative colonoscopy was performed in only one case and our follow-up programme was defective, with the longest period being 180 days. Conclusion. Mucocele of the appendix should be considered in the differential diagnosis of cystic lesions in the right lower abdomen. Owing to its rarity, it continues to intrigue the surgeon as well as the radiologist and pathologist alike. For mucinous cystadenocarcinoma, right hemicolectomy is usually needed, whereas for hyperplasia and cystadenoma, appendectomy usually suffices if the resection margins are free. For mucinous tumours of uncertain malignant potential and low grade mucinous tumours as well as pseudomyxoma peritonei, the decision is not as simple. As for laparoscopic surgery, no solid proof exists with or against its safety. Although not yet standardized, perioperative colonoscopy and regular follow-up to detect early recurrences should probably be part of the management plan.

Adenocarcinoma originating from a completely isolated duplication cyst of the mesentery in an adult.

Alimentary tract duplications are uncommon congenital abnormalities that usually have an anatomical connection with some part of the gastrointestinal tract and have a common blood supply with the adjacent segment of intestine. A completely isolated duplication cyst (CIDC) is a very rare type of gastrointestinal duplication that does not communicate with the normal bowel segment and possesses its own exclusive blood supply. Only 5 CIDC cases in adults have been reported in the English medical literature. Additionally, only 1 case of mucinous cystadenoma from an infected CIDC of the ileum has been reported. This report describes a 52-year-old male patient with a peritoneal CIDC, which upon curative excision was found to have given rise to an adenocarcinoma. The latter was lined internally with malignant glandular cells and contained a smooth muscular outer layer as determined by microscopic examination of the tissue. We believe that this is the first reported case of an adenocarcinoma originating from a CIDC in an adult.

血清CEA高値を契機に発見された虫垂粘液嚢胞腺腫の2例

血清CEA高値を契機に発見された虫垂粘液嚢胞腺腫の2例

Mucinous Cystadenoma in the Upper Lip

Mucinous cystadenoma of the salivary gland is a very rare disease, and only a few cases have been reported. We report here 2 cases of mucinous cystadenoma in the upper lip. The first case was a 57-year-old man and the second was a 42-year-old woman. The tumors were painless nodules with a smooth-surfaced mucosa, and surgical excisions were performed. Histologically, the tumors were surrounded by a fibrous capsule and were composed of multiple cysts lined with columnar epithelial cells. The tumor cells contain mucous substances that reacted with periodic acid-Schiff base and Alcian blue. Immunohistochemical staining revealed that the tumor cells expressed cytokeratin (AE1/3 and CK7), but their immunoreactivity with MIB-1 (Ki-67) was less than 3%. They had negative immunoreactivity for neuroectoderm markers, S-100 protein, and myoepithelial markers, p63, α-smooth muscle actin, and calponin, except for the accompanying myoepithelial-like cells. No recurrences were noted after surgery at 7 years and 1 year, respectively.

Laparoscopic spleen-preserving distal pancreatectomy (LSPDP).

To study the feasibility and safety of laparoscopic spleen-preserving distal pancreatectomy (LSPDP). Four patients underwent attempted LSPDP from February 2008 to April 2010 in our department and their clinical data and outcome were reviewed retrospectively. A total of 4 laparoscopic distal pancreas resections were attempted for 3 female and 1 male patient. All of these operations were successful with an average operative time of 235 min (range 115-305 min) and average blood loss of 200mL (range 100-450mL). The mean hospital stay time was 12.8 days, ranging from 10 to 21 days. Pancreatic fistula occurred in 1 patient then cured by extending drainage. Postoperative pathological examination showed those 2 cases of serous cystadenoma, 1 case of mucinous cystadenoma and 1 case of insulinoma, respectively. LSPDP is minimally invasive, safe and feasible for the management of benign pancreatic tail tumors with the advantages of earlier recovery and less morbidity from complications.

Laparoscopic distal pancreatectomy preserving the spleen and splenic vessels for benign and low-grade malignant pancreatic neoplasm.

Laparoscopic spleen-preserving distal pancreatectomy (LSPDP) is expected to be less invasive than laparoscopic distal pancreatectomy with splenectomy. However, there are few reports regarding the details of the procedure for LSPDP, and its safety remains unclear. This study aimed to evaluate the feasibility and safety of LSPDP. Six patients underwent LSPDP from March 2009 to February 2013 in our center, and their clinical data and outcomes were reviewed retrospectively. A total of six laparoscopic distal pancreatic resections were attempted in four female and two male patients. All of the operations were successful, with an average operative time of 290.7 min (range: 211-377 min) and an average blood loss of 43.5 g (range: 0-142 g). The mean hospital stay was 11.8 days (range: 9-17days). No obvious pancreatic fistulas occurred, although pseudocysts at the stump of the pancreas were recognized in three patients on CT scans performed at 7 days postoperatively. Postoperative pathological examinations revealed two cases of serous cystadenoma in the body and tail of the pancreas, one case of serous oligocystic adenoma, one case of mucinous cystadenoma, one case of neuroendocrine tumor, and one case of solid-pseudopapillary neoplasm. LSPDP is minimally invasive, safe, and feasible for the management of benign pancreatic tail tumors, with the advantages of earlier recovery and less morbidity from complications.

10年間の経過観察後に切除した膵粘液性嚢胞腺腫の1例

患者は74歳，女性．64歳時から径4cm大の膵尾部嚢胞性腫瘍にて外来で経過観察していた．当初，腫瘍径の増大は緩徐であった．4年後のERPにて主膵管と嚢胞の交通を認めた．4年4カ月後に急性膵炎を発症し，その3カ月後に腫瘍は7cm大に増大していた．初診から約10年後に心窩部つかえ感が出現し，精査にて腫瘍は11cm大に増大していた．ERPでは主膵管と嚢胞の交通は消失していた．膵粘液性嚢胞腫瘍を疑い，膵体尾部脾切除を施行した．腫瘍は厚い線維性被膜を有する嚢胞性病変で，卵巣様間質を一部に認め，粘液性嚢胞腺腫と診断された．膵粘液性嚢胞腫瘍はmalignant potentialを有すること，悪性例では予後不良で，術前の良悪性の鑑別診断は困難であることなどから切除が推奨されている．膵粘液性嚢胞腫瘍に対し長期間の経過観察をした後に切除した1例を経験したので，その自然史解明の一助になると考え，文献的考察を加えて報告する．

Mucinous cystadenoma of the appendix mimicking polycystic kidney disease

A 70-year-old Japanese male with auto-somal dominant polycystic kidney disease (AD-PKD) and chronic renal failure presented with abdominal distention. His family history was remarkable for ADPKD in his mother, a brother and a sister. He had been receiving hemodialysis for 10 years and his general health had other-wise been maintained. Computed tomography (CT) in the axial and coronal views showed both kidneys to have been almost completely replaced by multiple cysts and both occupied considerable space in the abdomen, consistent with ADPKD (Figure-1). It was also revealed that the largest cyst, which measured 160 mm in diameter, was located at the lower pole of the right kidney. Renal transcatheter arterial emboliza-tion was performed for both kidneys to achieve volume reduction because abdominal distention usually results from progressive dilatation of re-nal cysts and is therefore one of the most com-mon symptoms of ADPKD. Transcatheter arterial embolization is standard treatment for ADPKD at our hospital. Needle aspiration of the largest cyst was performed at the same time, and the cytological result was benign (Class II). Two years later, the patient presented again with progressive abdominal distention and pain. CT two years after embolization showed that only the largest cyst on the right side was refractory to treatment and had increased in size to 280 mm in diameter, while the other cysts had shrunk (Figure-2). Laparotomy was subsequently per-formed. During exploration of the abdominal cavity, the largest cyst, which was believed to be one of the renal cysts, was identified as be-ing completely separate from the aggregation of other cysts, instead being contiguous with the appendix. We performed an appendectomy together with resection of the largest cyst and right nephrectomy. Histological examination demonstrated mucinous cystadenoma of the ap-pendix. The postoperative course was unevent-ful. The patient has been closely followed up for one year without relapse. Mucinous cystadenoma is accounting for more than half of appendiceal mucoceles, cys-tic neoplasms characterized by distension of the appendiceal lumen with mucus. As histolgical subtypes, appendiceal mucoceles also include retention cysts, mucosal hyperplasia, and cyst-adenocarcinoma (1-4). CT scan or other imaging studies can lead to a presumptive diagnosis of an appendi-ceal mucocele. However, the differential diagno-sis can be challenging and should include cysts of other origins, especially, as in our case, when CT scan or ultrasonography is controversial, but fails to demonstrate the continuity of the lesion with the cecum (5,6). To our knowledge, this is one of the larg-est reported cases of mucinous cystadenoma of the appendix and also the first case associat-ed with ADPKD. There is a case of appendiceal mucinous cystadenoma of the same size as this case, which caused bilateral hydronephrosis and

Benign mucinous cystadenoma with stromal luteinization responsible for maternal virilization and fetal intrauterine growth restriction

Virilization caused by ovarian tumors with functioning stroma during pregnancy is extremely rare and has been reported to be due to different types of ovarian tumors. In mucinous cystadenomas with maternal virilization during pregnancy, the stromal cells responsible for hormone secretion resemble lutein or Leydig cells and have been referred to as luteinized stromal cells. Here we present a rare case of mucinous cystadenoma accompanied by virilization, which was also the cause of fetal intrauterine growth restriction during pregnancy and discuss the mechanisms of hormone production in these tumors in the light of the literature.

Large mucinous adenoma of pancreas presenting with recurrent pancreatitis

Cystic pancreatic tumors are an unfamiliar and rare entity even after the advent of modern abdominal imaging. Mucinous pancreatic tumors presenting with features of pancreatitis is a rare phenomenon moreover it creates a diagnostic dilemma and can lead to mismanagement. We report here such a case of mucinous cyst adenoma presented as recurrent pancreatitis and mimicking as a pancreatic pseudocyst. The correct diagnosis was made only on CT scan and was successfully treated by surgical excision in the form of distal pancreatectomy with splenectomy.

Primary Retroperitoneal Mucinous Tumors

Primary retroperitoneal mucinous tumors (PRMTs) are uncommon neoplasms occurring almost exclusively in women. PRMTs are divided into mucinous cystadenoma (MC), mucinous borderline tumors or tumors of low malignant potential (MLMP), and mucinous carcinomas (MCas). In this retrospective study, we present the clinicopathologic features of 18 such cases, the largest series to date. All patients were women, ranging in age from 20 to 63 years (mean 38.6 y). All except 2 patients presented with an enlarged mass during a routine examination or by self-palpation. All tumors were located exclusively in the retroperitoneum, with histologic or clinical confirmation of the lack of ovarian involvement. The tumors ranged from 7 to 26 cm (mean 13.2 cm). The gross appearance was variable: unilocular cyst with a thin wall (4 cases), predominantly cystic with papillary areas or nodule(s) (8 cases), multiloculated cyst with or without nodules (1 case each), and predominantly solid with cystic areas (4 cases). Histologically, there were 2 cases of MC, 7 of MLMP (7 cases; 3 of them with intraepithelial carcinoma and 1 with microinvasion), and 9 of MCas (9 cases, 5 of them associated with MLMP and 1 associated with MC). Three of the MCas had areas of anaplastic or sarcomatoid carcinoma whereas 1 had an associated sarcoma. Immunohistochemical studies were performed in 6 cases. Cytokeratin 7 was diffusely positive in all cases studied, whereas cytokeratin 20 and cytokeratin 17 were focally positive in 4 and 2 cases, respectively. All patients underwent surgical resection of the entire tumor. Two patients with MCa and sarcoma or sarcomatoid carcinoma received chemotherapy. Follow-up was available in 16 cases, ranging from 1 to 148 months (mean 40 mo, median 22 mo). Two patients died of disease at 5 and 9 months; both had MCa with anaplastic carcinoma or sarcoma. Three patients with MCa were alive with disease at 14, 26, and 58 months. The remaining patients were alive with no evidence of disease. In this study, MLMP and MCa were more common than MC. PRMTs seem to be nonaggressive neoplasms, except in cases containing anaplastic carcinoma or sarcoma.