Colloid Carcinoma Research Articles

Histomorphology of pancreatic cancer in patients with inherited ATM serine/threonine kinase pathogenic variants

Germline pathogenic variants in the ATM serine/threonine kinase (ATM) gene are associated with an increased risk of pancreatic ductal adenocarcinoma. It is important to identify germline ATM pathogenic variants in pancreatic cancer patients because these alterations are potentially targetable with chemotherapeutic drugs and/or radiation and have implications for other family members. As germline pathogenic variants in other genes have been associated with distinct histologic subtypes of pancreatic cancer, we studied the histomorphology of pancreatic cancer in 23 patients with germline ATM pathogenic variants. The histologic subtype was ductal adenocarcinoma in 19/23 (83%) of the patients, adenosquamous carcinoma in 1/23 (4%), and colloid (mucinous non-cystic) carcinoma in 3/23 (13%). The percentage of colloid (mucinous non-cystic) carcinomas is higher than we have previously observed in patients with familial and sporadic pancreatic cancer (1 and 2% in prior reports, p < 0.01 and p < 0.01, respectively). Three carcinomas (2 colloid carcinomas, 1 ductal adenocarcinoma) arose in association with intraductal papillary mucinous neoplasms. Among the resected pancreata, non-invasive precursor lesions, including pancreatic intraepithelial neoplasia and incipient intraductal papillary mucinous neoplasms, were identified in 83%. We conclude that pancreatic cancers in patients with germline ATM pathogenic variants are more frequently of colloid (mucinous non-cystic) morphology but are overall morphologically diverse supporting the utility of universal germline genetic testing for patients with pancreatic cancer.

GIANT PRIMARY COLLOID CARCINOMA OF THE LUNG

SESSION TITLE: Monday Medical Student/Resident Case Report Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: Colloid carcinomas of the lung are a very rare subset of lung adenocarcinomas. Historically, these neoplasms have been called mucinous cystic tumors and cystic mucinous adenocarcinomas. These tumors can grow very large and appear gelatinous and mucoid. We report a case of an extremely rare giant colloid carcinoma in a relatively asymptomatic patient. CASE PRESENTATION: The patient was a 55-year-old male with chronic kidney disease who was referred to our thoracic surgery service after a huge right lung mass was incidentally found during evaluation for renal transplantation. On MRI, it measured 11.8 x 9.4 x 13.1 cm and occupied most of the right chest cavity. The physical exam surprisingly demonstrated no abnormalities other than diminished breath sounds in the right lower lung base. Prior to surgery, bronchoscopy demonstrated endobronchial tumor extending from the right lower lobe into the intermedius bronchus. It was felt that the patient would require lower and middle lobectomy to obtain adequate tumor clearance. A hilar and lymph node dissection was started using the da Vinci robotic-assisted surgery system to see if adequate vascular control can be obtained in the hilum. After limited success a right thoracotomy was performed in order to complete the dissection and removal of the massive tumor. He made a satisfactory post-operative recovery and was discharged 10 days post-operatively doing well. Five month follow-up visit indicates that he is continuing to improve and currently waiting oncology clearance for consideration for kidney transplantation. The tumor was evaluated to have clear margins and measured 15.5 x 12.2 x 6.5 cm. Final pathologic diagnosis was a 15.5 cm colloid carcinoma of the lung with no evidence of lymph node metastasis. IHC staining revealed CK7 and CDX2 positive-staining tumor cells. DISCUSSION: Colloid carcinoma of the lung is a very rare diagnosis. These tumors are normally evident in breast tissue or the gastrointestinal tract. Because of the higher prevalence in tissues other than the lung, it is important to make sure the lung tumor is not a distant metastasis. In our case, it was important to rule out distant metastasis because of the patient’s potential renal transplantation status. The tumor’s IHC staining was consistent with colloid carcinomas of the lung. To our knowledge, our case represents one of the largest colloid carcinomas of the lung ever documented. The largest tumor we were able to find in the literature measured 15 cm at its largest. Our patient’s tumor measures 15.5 cm at the largest diameter. Complete resection tumor resection with mediastinal lymph node staging is the recommended treatment. CONCLUSIONS: The patient presented with an incidental and rare gigantic lung tumor. Despite the size of the tumor, it was completely resected with a possible cure. Reference #1: Moran CA, Hochholzer L, Fishback N, Travis WD, Koss MN. Mucinous (so-called colloid) carcinomas of lung. Modern pathology: an official journal of the United States and Canadian Academy of Pathology, Inc. 1992 Nov;5(6):634-8. Reference #2: Gao ZH, Urbanski SJ. The spectrum of pulmonary mucinous cystic neoplasia: a clinicopathologic and immunohistochemical study of ten cases and review of the literature. American journal of clinical pathology. 2005 Jul 1;124(1):62-70. Reference #3: Masai K, Sakurai H, Suzuki S, Asakura K, Nakagawa K, Watanabe SI. Clinicopathological features of colloid adenocarcinoma of the lung: A report of six cases. Journal of surgical oncology. 2016 Aug;114(2):211-5. DISCLOSURES: No relevant relationships by John Hallsten, source=Web Response No relevant relationships by Wickii Vigneswaran, source=Web Response

Clinicopathological and immunohistochemical study of mucinous carcinoma of breast

Introduction: Mucinous carcinoma (also known as colloid carcinoma) is a particular type of breast cancer characterized by the presence of extracellular mucin and is linked with a more favorable prognosis than invasive breast carcinoma of no special type. Mucinous carcinoma of the breast is an uncommon form of breast tumor, often presenting as a lobulated, moderately well circumscribed mass on mammography, sonography, and MRI imaging. It accounts for 1 to 7% of all breast cancers. Pure mucinous breast carcinomas are rare and account for about 2% of all primary breast carcinomas. Metastatic disease happens at a lower rate than in other types of invasive carcinoma. Aims and Objectives: To study the Clinic pathological and Immuno histochemical features of Mucinous Carcinoma Breast. Materials and Methods: We present our 2 year study from January 2016 to December 2018 on mucinous carcinoma of breast. Patients diagnosed with Pure MC and Mixed MC according to WHO classifications of tumors of breast 2012 were studied. Specimens were routinely processed and stained with Hematoxylin and eosin. Results: We identified 25 patients with mixed and pure mucinous breast cancer, the tumor size varied greatly from 2 to 19 cm in diameter. A subset of mixed mucinous carcinomas (8 cases) showed neuroendocrine differentiation or other associated premalignant lesions. Conclusion: Mucinous carcinoma of the breast is a rare entity with a favourable prognosis. In our study pure mucinous carcinoma accounted largest group and are seen at a younger age when compared to mixed mucinous carcinoma. Almost all the cases presented in stage p T2. Majority of the Pure MC did not show evidence of secondary deposit, whereas 50% cases of Mixed MC show secondary deposit. Most of cases of pure mucinous and mixed mucinous showed hormone receptor positivity. Older age at presentation, lesser tumor size and stage, hormonal receptor positivity are observed in our study, all of which are associated with good prognosis.

IPMN Never Fails to Surprise: A Rare Case of Colloid Carcinoma of Pancreas

IPMN Never Fails to Surprise: A Rare Case of Colloid Carcinoma of Pancreas

Colloid Carcinoma of Gallbladder - Incidental Finding of a Rare Entity

Majority gall bladder carcinomas are conventional adenocarcinomas of pancreatobiliary type. Mucinous carcinomas in gall bladder constitutes 2.5% of all gallbladder carcinomas. Pure mucinous (colloid carcinomas) are even rarer. Its rarity deserves this case being highlighted. Less than twenty-five cases of mucinous carcinomas of the gallbladder have been reported so far. A 46-year-old female presented with recurrent right upper quadrant pain along with nausea and vomiting for last one year. Liver function tests &amp; kidney function tests were within range. USG Abdomen revealed an enlarged gallbladder measuring 8x5 cm with no stones. No other abnormalities were found on USG. A simple cholecystectomy was performed for chronic cholecystitis. Gross examination of specimen showed glistening, globular, soft and cystic gall bladder filled with mucoid tenacious yellowish material. There was no discernible mass lesion. Microscopic examination revealed pools of extracellular mucinous material dissecting muscular wall containing few signet ring cells. A diagnosis of colloid or pure mucinous adenocarcinoma of the gallbladder was made. Pure mucinous carcinomas as seen in exocrine glands like breast, pancreas and skin are very uncommon in gall bladder. Mucinous variant (&gt;50% stromal mucin) are most of the time admixed with conventional type. Mucinous carcinomas most of the time are large and advanced at the time of diagnosis and are aggressive in nature than conventional type. This case is presented owing to its extreme rarity.

18F-FDG PET/CT imaging of distal pancreatic colloid carcinoma: a case report

18F-FDG PET/CT imaging of distal pancreatic colloid carcinoma: a case report

Assessment of pancreatic colloid carcinoma using 18F-FDG PET/CT compared with MRI and enhanced CT.

Pancreatic colloid carcinoma (CC) is a rare sub-type of pancreatic adenocarcinoma which has an improved prognosis compared with pancreatic ductal carcinoma. Consequently, the early detection of CC by imaging may be of great significance in guiding patient management and therapeutic decisions. The present study aimed to analyze 18F-FDG PET/CT findings of CC in comparison to MRI and CT. PET/CT findings in 5 patients with CC were retrospectively reviewed based on visual interpretation and semi-quantitative index of SUVmax and TNR. Four patients received dual-time-point PET/CT scans. Additionally, one patient underwent contrast-enhanced CT scan, one MRI, and three received both. A total of five lesions were detected in five patients. Visually, two cases presented with mild FDG uptake, two with moderate and one with high. The mean of SUVmax and TNR was 5.1±2.2 and 2.8±0.7, respectively. Compared with CCs with low SUVmax, CCs with high SUVmax were more aggressive. No distant metastases were observed in five cases. Among four patients with dual-time-point PET/CT imaging, SUVmax increased in three cases and decreased in one case. The mean early and delayed SUVmax were 4.2±1.1 and 4.7±1.9, respectively (P>0.05). Radiological findings mainly included septated cystic components, internal sponge-like contrast-enhancement, calcification and ‘salt-and-pepper sign’ on MRI T2-weighted imaging. Thus, PET/CT provided additional information on metabolic tumor activity as well as locoregional and distant staging, which are important prognostic markers and may improve further patient management. However, PET/CT did not show any findings in addition to MRI and contrast-enhanced CT that were unique to CC and allowed a clear differentiation from other pancreatic malignancies.

IPMNs with co-occurring invasive cancers: neighbours but not always relatives

ObjectiveIntraductal papillary mucinous neoplasms (IPMNs) are precursor lesions that can give rise to invasive pancreatic carcinoma. Although approximately 8% of patients with resected pancreatic ductal adenocarcinoma have a co-occurring IPMN,...

Colloid Carcinoma of the Uterine Cervix and Its Immunohistochemical Analysis: A Case Report.

Colloid carcinoma, which is a very rare tumor of the uterine cervix, is composed of an excessive amount of mucus and a relative paucity of tumoral glandular cells within them. Herein, we report a rare case of colloid carcinoma of the cervix with adenocarcinoma in situ (AIS), intestinal and usual types, and endocervical adenocarcinoma (usual type) components. We also discuss the morphological and immunohistochemical characteristics of this tumor. A 51-year-old woman was referred to our outpatient clinic with the symptom of genital bleeding lasting for 5 months. She had a cervix surrounded by an irregular tumor with a diameter of 5 cm. The colloid carcinoma cells were positive for MUC2, MUC5AC, and cytokeratin (CK) 7, focal positive for CDX2, and negative for MUC6 and CK20. Also, the intestinal type AIS showed a similar staining pattern. Colloid carcinoma cells producing mucin showed an intestinal phenotype and AIS. The intestinal type can be considered as a precursor lesion of colloid carcinoma.

Pancreas ductal adenocarcinoma with cystic features on cross-sectional imaging: radiologic-pathologic correlation.

Most pancreatic ductal adenocarcinomas (PDAs) show solid growth pattern, but ductal adenocarcinomas may demonstrate intratumoral cystic appearance or accompany peritumoral non-neoplastic cystic lesions, thus mimicking cystic pancreatic tumors on imaging studies. The histopathologic findings for PDA with cystic feature are divided into neoplastic and non-neoplastic cysts. Neoplastic cystic changes include large-duct type cysts (microcystic appearance), neoplastic mucin cysts (macrocystic appearance), colloid carcinomas (mucinous noncystic adenocarcinomas), and degenerative cystic change usually caused by hemorrhagic necrosis of tumor. Non-neoplastic cystic changes include retention cysts caused by ductal obstruction and pseudocysts caused by tumor-associated pancreatitis. Depending on the presence, size, number, and configuration of cystic changes, PDA should be differentiated from various types of cystic neoplasms. This pictorial essay provides histopathologic classification of PDAs with cystic features along with the corresponding cross-sectional imaging findings, and their differential diagnosis.

Pathologic classification of "pancreatic cancers": current concepts and challenges.

As the most common and most important cancer of the pancreas, with rapid mortality and now also as the third leading cause of cancer-related deaths in the United States, pancreatic ductal adenocarcinoma (PDAC) has become synonymous with "pancreas cancer". PDAC is also the prototype of the "pancreatobiliary-type" adenocarcinomas, along the biliary tract, ampullary and gallbladder cancers with the similar morphology and behavior. Recent molecular profiling studies have identified distinct subsets of PDAC, potentially with different behaviors and targetability. Moreover, while PDAC is by far the most common cancer of the pancreas, there are various other types that occur in this organ and are erroneously classified together with PDAC. Many of these have different molecular and biologic characteristics that warrant their management separately although they are also technically "pancreatic cancers". While some are closely related to PDAC and have as aggressive behavior (such as adenosquamous carcinomas which are recently recognized under "basal" like category in profiling studies, which are actually even worse prognostically than PDACs), in the meantime, others such as colloid carcinoma has a much better behavior than PDAC, and as a carcinoma with intestinal lineage (MUC2/CDX2) colloid carcinoma may require an entirely different treatment approach as well. Similarly, medullary carcinomas also appear to have different biology. Additionally, non-ductal cancers such as acinar, neuroendocrine, solid-pseudopapillary neoplasms and pancreatoblastoma have their respective clinicopathologic and molecular associations and warrant careful elimination in the management and study protocols. Another very problematic aspect in the classification of "pancreas cancer" is its delineation from the cancers of neighboring organs, in particular, ampullary/duodenal and common bile duct (CBD) cancers, for which recently more refined criteria have been provided. Additionally, the possibility of metastasis from another site and lymphomas also need to be considered. In summary, there is a whole host of cancers that occur in the pancreas that ought to be considered carefully before a case is classified as an ordinary "pancreas cancer" (PDAC).

Pancreatic Colloid Carcinoma in an Elderly Cat

A 21-year-old neutered female domestic shorthaired cat was presented with a history of inappetence, vomiting and haematuria. The cat was humanely destroyed at the owner's request and a necropsy examination was performed. A 0.8×0.5×0.5cm mass was located in the left lobe of the pancreas. The mass was gelatinous in nature and the external and cut surfaces were pale yellow in colour. Microscopically, the mass was non-capsulated and comprised an accumulation of extracellular stromal mucin containing suspended neoplastic columnar epithelial cells forming tubular structures. Immunohistochemically, these cells diffusely expressed cytokeratin (CK) AE1/AE3, CK7 and carcinoembryonic antigen and were partially positive for CK19 and trypsin, but negative for vimentin. The tumour was diagnosed as a colloid carcinoma. The clinical presentation in this case was caused by chronic renal failure complicated by secondary renal hyperparathyroidism and associated metastatic calcinosis. To the best of our knowledge, this is the first report of colloid carcinoma arising from the pancreas in a cat.

Laryngeal and vocal alterations after thyroidectomy.

IntroductionDysphonia is a common symptom after thyroidectomy.ObjectiveTo analyze the vocal symptoms, auditory-perceptual and acoustic vocal, videolaryngoscopy, the surgical procedures and histopathological findings in patients undergoing thyroidectomy.MethodsProspective study. Patients submitted to thyroidectomy were evaluated as follows: anamnesis, laryngoscopy, and acoustic vocal assessments. Moments: pre-operative, 1st post (15 days), 2nd post (1 month), 3rd post (3 months), and 4th post (6 months).ResultsAmong the 151 patients (130 women; 21 men). Type of surgery: lobectomy + isthmectomy n = 40, total thyroidectomy n = 88, thyroidectomy + lymph node dissection n = 23. Vocal symptoms were reported by 42 patients in the 1st post (27.8%) decreasing to 7.2% after 6 months. In the acoustic analysis, f0 and APQ were decreased in women. Videolaryngoscopies showed that 144 patients (95.3%) had normal exams in the preoperative moment. Vocal fold palsies were diagnosed in 34 paralyzes at the 1st post, 32 recurrent laryngeal nerve (lobectomy + isthmectomy n = 6; total thyroidectomy n = 17; thyroidectomy + lymph node dissection n = 9) and 2 superior laryngeal nerve (lobectomy + isthmectomy n = 1; Total thyroidectomy + lymph node dissection n = 1). After 6 months, 10 patients persisted with paralysis of the recurrent laryngeal nerve (6.6%). Histopathology and correlation with vocal fold palsy: colloid nodular goiter (n = 76; palsy n = 13), thyroiditis (n = 8; palsy n = 0), and carcinoma (n = 67; palsy n = 21).ConclusionVocal symptoms, reported by 27.8% of the patients on the 1st post decreased to 7% in 6 months. In the acoustic analysis, f0 and APQ were decreased. Transient paralysis of the vocal folds secondary to recurrent and superior laryngeal nerve injury occurred in, respectively, 21% and 1.3% of the patients, decreasing to 6.6% and 0% after 6 months.

Diabetes mellitus in intraductal papillary mucinous neoplasm of the pancreas is associated with high-grade dysplasia and invasive carcinoma

BackgroundWhile the association between Diabetes Mellitus (DM) and pancreatic ductal adenocarcinoma is well recognized, its importance in intraductal papillary mucinous neoplasm of the pancreas (IPMN) is not well-defined. We sought to examine the associations of DM with degree of dysplasia and morphological subtypes in IPMN. MethodsIn 454 patients with resected IPMN, we evaluated associations of DM with high-grade dysplasia (HGD), invasive carcinoma, precursor epithelial subtype (gastric, intestinal, oncocytic, pancreatobiliary), and histological type of invasive carcinomas (tubular, colloid, oncocytic) using logistic regression. We performed multivariate analyses adjusting for worrisome features and high-risk stigmata of malignancy in a subset of 289 patients with annotated radiological characteristics. ResultsThe prevalence of DM in our study was 34%. DM was significantly associated with HGD (OR 2.02, 95% CI 1.02–4.01, P = 0.045) and invasive carcinoma (OR 2.05, 95% CI 1.08–3.87, P = 0.027) after adjusting for worrisome features. Compared to patients without DM, those with recent-onset DM (≤5 years before surgery) had 6.9-fold (95% CI 2.38–19.92, P < 0.001) higher risk of invasive carcinoma. DM was associated with increased likelihood of intestinal-type precursor epithelium (OR 1.63, 95% CI 1.07–2.47, P = 0.022) and colloid carcinomas (OR 2.46, 95% CI 1.01–5.99, P = 0.047) ConclusionPreoperative DM was associated with significantly higher risk of HGD and invasive carcinoma in resected IPMN, and risk of invasive carcinoma was highest in patients with recent-onset DM. Patients with DM were more likely to harbor intestinal-type IPMN and colloid carcinomas. Our findings suggest that a diagnosis of DM in patients with IPMN may warrant more aggressive surveillance.

Giant Intracystic Papillary Carcinoma of the Breast Report of a Case and Review of the Literature

Background: Intracystic papillary carcinoma (IPC) is a distinctive variant of a papillary ductal neoplasm confined to a dilated cystic space. This rare mammary tumor typically appears as a discrete solitary mass in the central region of the breast in a postmenopausal woman. This article presents the case of a female patient with a giant IPC. Relevant literature is briefly reviewed. Case: A 65-year-old woman was admitted for the management of a palpable mass of the left breast. On clinical examination, it was noted that the entire left breast was replaced by an extremely large, irregularly shaped, relatively mobile lesion. The mass was almost fixed to surrounding tissues including skin and pectoral muscle. Due to the size of the tumor the patient underwent a left modified radical mastectomy. Results: The final histopathologic diagnosis was defined as an IPC. Concomitant vascular invasion or metastasis to 19 removed lymph nodes were not noted. Conclusions: Because of its relevant growth pattern and indolent clinical behavior, IPC is conventionally regarded as a variant of intraductal papillary carcinoma with an absence of myoepithelial cells. There have been several cases that indicated a slow evolution of the mass, verifying the perception that IPC is associated with a favorable clinical outcome. Differential diagnoses include colloid or medullary carcinoma, invasive ductal carcinoma, hematoma, benign cyst, or adenofibroma. Axillary lymph-node metastases and markers related to invasion have been documented. Due to the rarity of the tumor and variability observed in treatment strategies, only a few surveys have assessed the significance of lymph-node status and the role of adjuvant treatment. (J GYNECOL SURG 2017:1)

Mucinous Noncystic Colloid Carcinoma of the Pancreas with Solitary Hepatic Metastasis: A Rare Presentation

Mucinous noncystic (colloid) carcinoma (MNCC) of the pancreas is considered an uncommon variant of ductal adenocarcinoma of the pancreas with specific histopathological and molecular features. We report the CT findings of large area of hypoattenuation and intratumoral calcification in a pathologically proven case of mucinous non-cystic carcinoma of the pancreas. MNCC of the pancreas is a distinct entity that needs to be radiologically differentiated from the ductal adenocarcinoma as usually it has more favorable outcome when compared to the rapidly fatal course of ductal adenocarcinomas. But in our index case, it was associated with a large solitary hepatic metastasis with similar calcific foci, which to the best of our knowledge has not been described in the English literature till date.c

Pancreatic serous cystic neoplasms accompanying other pancreatic tumors

Serous cystic neoplasms (SCNs) are benign cystic neoplasms that predominantly occur in the tail of the pancreas in elderly women. It is well known that patients with von Hippel-Lindau syndrome can develop SCNs and neuroendocrine tumors in the pancreas. However, our understanding on SCNs accompanying other pancreatic tumors (SCNAOPTs) is limited. We compared the clinicopathological features of 15 surgically resected SCNAOPTs with 259 conventional SCNs. The prevalence of SCNAOPT was 5%. The SCNAOPTs were significantly smaller than conventional solitary SCNs, and they were more commonly observed in the head of the pancreas, whereas conventional solitary SCNs were more frequently noted in the body and tail. However, no differences were found in terms of sex, patient age, or the gross patterns of the SCNs. Accompanying neoplasms included 7 intraductal papillary mucinous neoplasms, 1 colloid carcinoma arising from intraductal papillary mucinous neoplasm, 6 neuroendocrine tumors, and 1 solid pseudopapillary neoplasm. Four neuroendocrine tumors associated with von Hippel-Lindau syndrome occurred as multiples, whereas 2 neuroendocrine tumors without von Hippel-Lindau syndrome were solitary. In summary, SCNAOPTs comprise 5% of all SCNs and tend to be smaller and located in the head of the pancreas. Common accompanying tumors include intraductal papillary mucinous neoplasms, neuroendocrine tumors, and other neoplasms such as colloid carcinoma and solid pseudopapillary neoplasm.

Intraductal papillary neoplasms of intrahepatic bile duct: a clinicopathologic study of 25 cases

To study the clinicopathologic and immunohistochemical features of intraductal papillary neoplasms of the bile duct (IPNB) of the intrahepatic bile duct. The clinical findings, morphologic features and immunophenotype of 25 cases of IPNB were investigated. Of the 25 cases of IPNB, 18 were in the left lobe, 6 were in the hilar bile duct, and 1 was in the right lobe. The average age was 60.6 (26-73) years. The presenting symptom was abdominal pain in 15 cases. Imaging results were variable, including multilobular cysts, mass lesions within the dilated ducts, cholangiolithiasis with dilated bile duct, and solid mass. Gross examinations were concordant with imaging findings. Microscopically, all the IPNB could be divided into four papillary patterns, including 12 gastric type, 8 intestinal type, 4 pancreatobiliary type and 1 oncocytic type. Five IPNB showed mild to moderate atypia, 10 showed high-grade atypia and 10 IPNB were associated with carcinomas.The invasive IPNB were mainly bile duct adenocarcinomas(9 cases), and rarely colloid carcinoma (1 case). Immunohistochemically, IPNB expressed MUC5AC (96.0%, 24/25), MUC2 (32.0%, 8/25), MUC6 (40.0%, 10/25) and MUC1 (12.0%, 3/25). The different MUC expression was commonly associated with specific histological subtype. IPNBs are rare cystic and premalignant neoplasms of the liver. The imaging features vary, but show a common feature of dilated bile duct. The pathologic types and classifications are similar to intraductal papillary mucinous neoplasm of the pancreas. The MUC stains are helpful in diagnosis and histological subtyping.

Intraductal papillary mucinous neoplasm of pancreas: analysis of the clinicopathologic features and prognosis

To study the clinicopathologic and immunohistochemical features, and the prognosis of intraductal papillary mucinous neoplasms (IPMN) of the pancreas. The clinical findings, morphologic features, immunophenotype and prognosis were investigated in 61 cases of IPMN. Of these 61 cases, 33 were in the pancreatic head and 14 were in the body and tail, and 14 in the entire pancreas. The average patients' age was 61.8 years. The initial symptom was abdominal pain in 37 cases, and the tumors were detected at routine checkup in 14 cases. The imaging examination showed dilated ducts and/or cystic and solid masses. Grossly, 32 cases were multi-loculated cystic masses containing mucin and papillary areas; 13 cases were solid. Microscopically, the IPMN showed four patterns, including gastric-type (16 cases), intestinal-type (21 cases), pancreatobiliary-type (21 cases) and eosinophilic-type (3 cases). The IPMN cohort included 13, 13 and 6 IPMN with low, intermediate and high-grade dysplasia respectively, and 29 IPMN associated with invasive carcinoma. The IPMN associated carcinomas were mainly ductal adenocarcinoma (23/29, 79.3%), followed by colloid carcinoma (4/29, 13.8%) and undifferentiated carcinoma (2/29, 6.9%). Immunohistochemically, IPMN expressed MUC5AC (51/57, 89.4%), MUC2 (21/57, 36.8%), and MUC1 (13/46, 28.3%). The mean postoperative follow-up period was 32 months (range 12-112 months). Six of 61 patients were lost to follow-up. Overall 5-year survival rate was 76%. The 5-year survival rate of IPMN with low, intermediate or high-grade dysplasia was 100%, and recurrence was local in 3 patients. The 3-year survival rate of IPMN associated with invasive carcinoma was 55%. 12 of 13 patients died within 2 years after operation. IPMN is a common cystic neoplasm of the pancreas located in the ducts. The pathologic types and classifications are clearly defined. MUC stains are helpful for the diagnosis and papillary typing. IPMN with invasive carcinoma was associated with significantly worse survival than IPMN with dysplasia.

Mucinous carcinoma of breast in a 30-year-old female: A rare case report and discussion

Mucinous carcinoma (MC) (colloid carcinoma) is a particular, rare type of breast carcinoma. It is characterized by the presence of extracellular mucin. MC of the breast generally presents as a lobulated, moderately well-circumscribed mass on mammography, sonography, and magnetic resonance imaging. It has a favorable prognosis due to the low incidence of axillary lymph node metastasis and poor adherence to bottom fascia and poor infiltration of overlying skin. It has high incidence of estrogen receptor and progesterone receptor positivity. The incidence of MC in females under 35 years of age is only 1%. Here, we report a case of MC of right breast in a 30-year-old female.