Mucin-producing Adenocarcinoma Research Articles

Comparative effectiveness of chemotherapy in different histological types of pancreatic cancer: a PSM-based study using the SEER database

This study aimed to compare the effectiveness of chemotherapy in different histological types of pancreatic cancer using data collected from the Surveillance, Epidemiology, and End Results (SEER) database. Patients who were diagnosed with pancreatic cancer between 2004 and 2015 were selected from the SEER database. Propensity score matching (PSM) was employed to minimize the selection bias. The Kaplan-Meier survival curves and the log-rank test were utilized to compare the overall survival (OS) and cancer-specific survival (CSS) among different groups. Of the 7,653 pancreatic cancer patients, both OS and CSS were higher in the chemotherapy group than those in the non-chemotherapy group (p < 0.001). After PSM, 2381 pairs were generated. The Kaplan-Meier survival curved indicated that both OS and CSS for pancreatic ductal adenocarcinoma (PDAC), pancreatic adenosquamous carcinoma (PASC), and pancreatic mucin-producing adenocarcinoma (PMPAC) (p < 0.001) in the chemotherapy group were superior to those in the non-chemotherapy group, while there was no significant difference in pancreatic mucinous adenocarcinoma (PMAC) (p = 0.2586). Compared with PASC and PMPAC, PDAC exhibited longer OS and CSS. The results of statistical analysis showed that PASC tumors were mainly poorly differentiated, and the majority of patients with PMPAC had distant metastasis. Chemotherapy could prolong pancreatic cancer patients’ survival, especially for patients with advanced disease. PMPAC patients had a higher rate of metastasis, accompanying with the worse survival.

A survival comparison of gastric mucin-producing adenocarcinoma to conventional adenocarcinoma: a SEER database analysis

BackgroundCompared to conventional adenocarcinoma (CA), mucin-producing adenocarcinoma (MPA) is an uncommon histological subtype and is usually separated from other histological types and has been evaluated separately. The objective was to compare the clinicopathological characteristics and survivals of MPA with CA.MethodsWe retrospectively analyzed 1515 MPA patients in SEER database. Log-rank tests and KM survival curves were applied to determine the differences in overall survival (OS) and cancer specific survival (CSS) time.ResultsNo significant differences were noted in OS and CSS time. The MPA patients who were treated with surgery and chemotherapy exhibited longer OS and CSS time periods than those without treatment. MPA patients treated with radiotherapy exhibited similar OS and CSS time with those without radiotherapy. MPA was not a prognostic factor of survival.ConclusionsMPA was a rare histological type of gastric cancer. Patients with MPA exhibited similar prognosis with those with CA. Surgery and chemotherapy were effective treatments for patients with MPA.

A CASE OF MUCIN-PRODUCING UROTHELIAL-TYPE ADENOCARCINOMA OF THE PROSTATE (MPUAP) WITH LONG-TERM SURVIVAL AFTER TOTAL CYSTECTOMY

Mucin-producing urothelial-type adenocarcinoma of the prostate (MPUAP) is a very rare disease. MPUAP has been reported to progress faster than the rate at which normal prostate cancer progresses. We report a case of MPUAP with long-term survival. The patient was a 65-year-old man. Computed tomography and magnetic resonance imaging showed a cystic lesion extending from the prostate to the urethra. We performed transrectal prostate biopsy and transurethral resection of the tumor, and the pathological diagnosis was adenocarcinoma. Subsequently, we performed total cystectomy, ureterostomy, and pelvic lymphadenectomy. Based on the pathological and immunostaining findings (prostate-specific antigen negativity, CDX-2 positivity, cytokeratin 20 positivity, 34β-E12 positivity), the patient was diagnosed with MPUAP. Four years after the surgery, recurrence or metastasis was not observed.

Urethral Mucinous Adenocarcinoma of the Prostate: An Uncommon and Diagnostically Complex Disease

A 66-year-old male presented with hematuria and mucosuria. A transurethral resection of the prostate revealed adenocarcinoma in situ with mucinous features. He underwent a robotic-assisted radical prostatectomy with lymph node dissection. Pathology confirmed T2 primary mucin-producing urothelial type adenocarcinoma in the prostatic urethra. Urothelial adenocarcinoma arising in the prostatic urethra is an uncommon disease that warrants clear differentiation from other malignancies due to its aggressive nature. The differential includes urologic and gastrointestinal malignancies making diagnosis complex. Accurate diagnosis is critical to providing appropriate treatment as these patients are at high risk of developing recurrence and metastatic disease.

Glycerophosphodiester phosphodiesterase 1 (GDE1) acts as a potential tumor suppressor and is a novel therapeutic target for non-mucin-producing colon adenocarcinoma.

Colon adenocarcinoma (COAD) represents a major public health issue due to its high incidence and mortality. As different histological subtypes of COAD are related to various survival outcomes and different therapies, finding specific targets and treatments for different subtypes is one of the major demands of individual disease therapy. Interestingly, as these different subtypes show distinct metabolic profiles, it may be possible to find specific targets related to histological typing by targeting COAD metabolism. In this study, the differential expression patterns of metabolism-related genes between COAD (n = 289) and adjacent normal tissue (n = 41) were analyzed by one-way ANOVA. We then used weighted gene co-expression network analysis (WGCNA) to further identify metabolism-related gene connections. To determine the critical genes related to COAD metabolism, we obtained 2,114 significantly differentially expressed genes (DEGs) and 12 modules. Among them, we found the hub module to be significantly associated with histological typing, including non-mucin-producing colon adenocarcinoma and mucin-producing colon adenocarcinoma. Combining survival analysis, we identified glycerophosphodiester phosphodiesterase 1 (GDE1) as the most significant gene associated with histological typing and prognosis. This gene displayed significantly lower expression in COAD compared with normal tissues and was significantly correlated with the prognosis of non-mucin-producing colon adenocarcinoma (p = 0.0017). Taken together, our study showed that GDE1 exhibits considerable potential as a novel therapeutic target for non-mucin-producing colon adenocarcinoma.

Comprehensive analysis in mucin-producing urothelial-type adenocarcinoma of the prostate: case study with literature review.

It is critical to distinguish the rare neoplasm of mucin-producing urothelial-type adenocarcinoma of the prostate (MPUAP) from either prostate origin or metastatic adenocarcinoma. This is mainly because they have different tumor staging, clinical behavior and treatment plans. In the current study, we try to fulfill the lack of knowledge in this field. There were totally 24 MPUAP cases including previous reported 23 cases and adding one new MPUAP case in the current study. We performed IHC and 78 genes panel analysis in two cases of ours. Most of the cases had urinary obstruction symptoms and normal PSA level. Pathological features showed dissection of the stroma by mucin pools and glands lined by pseudostratified columnar mucinous epithelium with varying degrees of cytological atypia. The IHC results showed positive for CK20, CEA, CDX-2, β-catenin, p53, MUC2 and MUC5AC, negative for PSA, AMACR, GATA3, MUC6, AR and NKX3.1 and variable expression for HMWCK and CK7. Genetic analysis revealed concurrent mutations of FAT1 (c.10001 T>C) and HNF1A in both cases. The similar morphology features of MPUAP and colorectal adenocarcinoma were seen. Membranous staining pattern of β-catenin and genetic mutation of FAT1 and HNF1A are two distinct features in MPUAP.

Aggressive course in a patient with mucin-producing urothelial-type adenocarcinoma of the prostate: A case report and review of the literature.

Prostate cancer is one of the frequently seen types of cancers in men. The most frequent histological type of prostate cancer is the acinar adenocarcinoma. Mucin-producing urothelial-type adenocarcinoma of the prostate is a very rare subtype. The mucin-producing urothelial-type adenocarcinoma of the prostate has microscopic similarities with colon and bladder adenocarcinoma. It has a more aggressive clinical course and does not respond to androgen deprivation therapy. A 77-year-old male patient diagnosed with mucinous prostate cancer was presented in the current case report.

Trousseau's syndrome associated with pulmonary pleomorphic carcinoma exhibiting aggressive features: A case report.

Trousseau's syndrome is characterized as an unexpected, cancer-related thrombotic event, such as a cerebral infarction or a deep vein thrombosis/pulmonary embolism. We describe the first reported case of Trousseau's syndrome with pulmonary pleomorphic carcinoma and aggressive features. A 74 year-old man presenting with a pulmonary mass, which was identified as pleomorphic carcinoma with extensive lymph node involvement, in the left lower lobe, underwent a left lower lobectomy. Immunohistochemical analysis revealed that neoplastic cells exhibited an extensive expression of tissue factors with a mucin-producing adenocarcinoma component. Three months postoperatively, diffuse infiltration rapidly appeared in the left lung, which was identified as lymphangitic carcinomatosis via bronchoscopy. Prior to treatment for cancer recurrence, the patient presented with a left hemiplegia due to a cerebral infarction via multiple thromboses, with no evidence of atherosclerotic or cardiogenic thrombi. Elevated D-dimer and carbohydrate antigen 125 levels and the presence of a fibrin thrombus retrieved from the occluded vessel suggested Trousseau's syndrome as the etiology of the brain infarction. A hypercoagulable state associated with the aggressive recurrence of pulmonary pleomorphic carcinoma, accompanied by cancer cell production of mucin and tissue factors may be a potential mechanism for cancer-related thrombosis.

Clinical characteristics and prognosis of different primary tumor location in colorectal cancer: a population-based cohort study

PurposeEmerging data have shown that patients with left-sided cancers have better survival than patients with right-sided cancers in terms of metastatic colorectal cancer. However, the available information and findings remain limited and contradictory in localized colorectal cancer. This study aimed to evaluate the clinical characteristics and prognosis of primary tumor location (PTL) in colorectal cancer.MethodsPatients’ diagnoses were identified using the Surveillance, Epidemiology, and End Result database between 2006 and 2015. The analyses were further stipulated to patients with primary cancer site, histology, and stage information. The correlations between PTL and overall survival (OS) were assessed.ResultsCompared with left-sided tumors, right-sided tumors were more likely to develop into T3 cancers (50.0% vs. 44.8%), T4 cancers (15.8% vs. 12.3%), mucinous or mucin-producing adenocarcinoma (10.8% vs. 5.0%), and signet ring cell carcinoma (1.4% vs. 0.7%), P < 0.01, respectively. Patients with right-sided tumors showed inferior OS (56.1% vs. 60.2%), and the hazard ratio was 1.224 (95% CI, 1.208–1.241, P < 0.001) in all stages. Stage-specific Cox regression analysis revealed that patients with right-sided tumors also showed inferior OS in every stage (respectively, P < 0.05) than left-sided tumors.ConclusionsThis study demonstrated that the prognoses of patients with left-sided cancers were better than those of patients with right-sided cancers regardless of stage. PTL can be a prognosis factor in colorectal cancer. We encourage developing clinical and translational studies to elucidate the causative relationship between PTL and prognosis.

Assessment the of Amplification HER-2/neu Gene by Chromogenic In Situ Hybridization (CISH) Compared to Immunohistochemistry (IHC) Method in Gastric Cancer

Abstract Background: Gastric cancer has a highmortality rate and often has a poor treatment outcome. The HER2/neu gene target therapy has been known as a potential way for treatment. Objectives: The goal of our study was assessment the relation between chromogenic in situ hybridization (CISH) and immunohis- tochemistry (IHC)methods in determining the best diagnosticmethod for gastric cancer. Methods: In this historical cohort study, 50 gastric cancer samples were analyzed by CISH and IHC. The relation between clinical- pathological parameters of HER2/neu was also analyzed. Alive patients were followed from 2009 through 2012 for the main out- comes (mortality). The results of these twomethods, in terms of sex, age, tumor size, grading, staging, tumor location,metaplasia, presence of necrosis and ulceration, vascular invasion, the TNM system, mucin or signet producing adenocarcinoma cells and pa- tient survival rates were compared. Results: There was no significant difference between IHC and CISH regarding the sex, age, tumor size, grading, staging, tumor lo- cation,metaplasia, presence of necrosis and ulceration, vascular invasion, the TNMsystem,mucin or signet producing adenocarci- noma cells and patient survival rates. Comparison of TNMscores by these twomethods showed no significant relationship between IHC and staging, but a statistically significant difference between CISH and different N staging, (P < 0.05) was assessed. Conclusions: Comparison between IHC and CISH showed the only significant relationship between CISH and different N staging. Therefore, low amplified CISH was a better diagnosticmethod for gastric cancer, compared to low expression in IHC.

Mucinous and secondary tumors of the prostate

Primary mucinous tumors and secondary tumors involving the prostate gland are relatively uncommon, however they have important diagnostic, therapeutic, and prognostic implications. The primary mucinous tumors of the prostate include mucinous (colloid) adenocarcinoma of the prostate, prostatic adenocarcinoma with mucinous features, and mucinous adenocarcinoma of the prostatic urethra (mucin-producing urothelial-type adenocarcinoma of the prostate). Mucinous adenocarcinoma of the prostate is defined as a primary prostatic acinar tumor characterized by the presence of at least 25% of the tumor composed of glands with extraluminal mucin. This diagnosis can only be made in radical prostatectomy specimens. Recent studies have shown that these tumors have a similar or in some cases better prognosis than conventional prostatic adenocarcinoma treated by radical prostatectomy. The preferred terminology for tumors that are composed of <25% extraluminal mucinous component in radical prostatectomy specimens is 'prostatic adenocarcinoma with mucinous features.' All cases of prostatic adenocarcinoma with extraluminal mucinous components in prostate needle core biopsies or transurethral resection of the prostate specimens are also referred to as 'prostatic adenocarcinoma with mucinous features.' Mucinous adenocarcinoma of the prostatic urethra (mucin-producing urothelial-type adenocarcinoma of the prostate) as the name implies, does not arise from prostatic acini or ducts, and is a distinct entity that arises from the prostatic urethra usually from urethritis glandularis or glandular metaplasia with malignant transformation, and is analogous to adenocarcinoma with mucinous differentiation arising from the urinary bladder. This tumor is aggressive and has a relatively poor prognosis. The most common secondary tumors that arise from adjacent organs and spread (direct extension or metastasis) to the prostate gland, include urothelial carcinoma of the bladder and colorectal adenocarcinoma. Other secondary tumors that may involve the prostate include metastatic epithelial tumors from several other sites, malignant melanoma and soft tissue tumors.

Colorectal signet ring cell carcinoma: Influence of EGFR, E-cadherin and MMP-13 expression on clinicopathological features and prognosis.

Signet ring cell carcinoma (SRCC) is unique rare subtype of mucin-producing colorectal adenocarcinoma characterized by presence of signet ring cells, in >50% of the tumor tissue. This study aims to investigate expression of EGFR, E-cadherin and MMP-13 expression on clinicopathological features of signet ring cell type and its prognostic effect using manual tissue microarray technique. In this work, we studied tumor tissue specimens from 150 patients with colorectal cancer cases among which 19 cases of SRCC. High density manual tissue microarrays were constructed using modified mechanical pencil tips technique and immunohistochemistry for EGFR, E-cadherin and MMP-13 expression was done. We found that SRCC was significantly associated with younger age and more frequency of LN metastasis than all other groups. SRCC was also significantly associated with annular gross picture, more depth of invasion, advanced stage, more lymphovascular emboli, more perineural invasion and less arousal from an overlying adenoma. In conclusion, colorectal SRCC has distinctive clinicopathological and histological features with different unique mechanisms of carcinogenesis and more aggressive biologic behavior than other colorectal carcinoma subtypes. Negative/low expressions of EGFR and E-cadherin and MMP-13 were found in SRCC with no effect on the prognosis.

Metastatic Mucin-Producing Adenocarcinoma

Introduction: Gallbladder adenocarcinoma is a rare, aggressive, and lethal malignancy affecting 7,000 individuals annually. Case Report: We present a case of 58-yr-old female, with a family history of colon cancer at age 50, with worsening abdominal pain beginning 2 weeks ago and worsening over the last 2 days. She stated that the abdominal pain began in the RUQ and began spreading to the LUQ. Associated symptoms included nausea and vomiting. She admitted to a negative FOBT with her PCP, 1 week prior to presentation. Physical exam was notable for RUQ tenderness to palpation. On admission, she was noted to have mild leukocytosis of 12.9, elevated ALK Phos of 766, AST of 117, and ALT 95. An US of the RUQ showed multiple gallstones and extra-hepatic CBD measurement of 6 mm along with liver masses of mixed echogenicity. CT showed thickened gallbladder wall and a large gallstone. The patient was started on antibiotics and referred to surgery. During the procedure, the patient was noted to have a choleduodenal fistula and the gallbladder was noted to be too friable for traction. The procedure was converted to open, gallbladder was removed, and the fistula was repaired. Intraoperative frozen section was negative for neoplasia. Further pathology/staining showed an infiltrating, poorly differentiated mucin-producing adenocarcinoma originating from the gallbladder. Subsequently, patient underwent CT guided biopsy of the liver masses and was found to have metastatic gallbladder adenocarcinoma of the liver. Hematology/oncology was consulted and a chemo port was surgically placed. EGD and colonoscopy were negative. The patient was discharged for outpatient for chemotherapy. Discussion: Gallbladder adenocarcinoma is a rare diagnosis. Predisposing factors include older age, female gender, and gallstones. Due to vague symptomatology, presentation is generally at advanced stages with a 5-year survival rate of less than 5%. Metastasis to adjacent organs, such as liver, along with biliary obstruction is also noted at diagnosis. Stage of the disease at diagnosis alters treatment options. Non-radical surgery alone may be recommended at stage 0, I, and II. Advanced disease may be offered radical surgery. Metastasis may be limited in therapeutic options altogether. Conclusion: Diagnosis of gallbladder carcinoma is often delayed due to vague presenting symptoms. If diagnosed early, curative surgery may be offered. However, late diagnosis leads to poor survival prognosis.

Prognostic analysis of primary mucin-producing adenocarcinoma of the lung: a comprehensive retrospective study.

Although primary mucin-producing adenocarcinoma of the lung is uncommon, each subtype has distinct clinical, pathological, molecular, and prognostic characteristics. This study aimed to determine correlations between clinical and pathological features and genetic phenotypes with the prognosis. We immunohistochemically examined the protein levels of thyroid transcription factor 1 (TTF-1), Napsin A, and anaplastic lymphoma kinase (ALK) and genetically examined epidermal growth factor receptor (EGFR) and KRAS mutations in these mucin-producing tumors. A total of 75 cases of mucin-producing adenocarcinoma of the lung were examined. ALK protein positivity was 33.3% (25/75), and primarily occurred in solid predominant with mucin production subtype (SA). KRAS mutations occurred in 22.7% (17/75) of patients, predominantly in invasive mucinous adenocarcinoma (IMA). Positive TTF-1 and Napsin A expression was more common in SA, while they were both negative in IMA. The 1-, 3-, and 5-year progression-free survival rates of mucin-producing lung adenocarcinoma were 85, 64, and 38%, respectively; the overall survival rates were 90, 67, and 50%, respectively. Larger tumors, advanced stage, and lymph node metastasis were associated with poor prognosis. Mucinous minimally invasive adenocarcinoma (m-MIA) had the best prognosis, followed by IMA, SA, and acinar or papillary predominant adenocarcinoma with mucin production (A/P). KRAS mutations were an independent positive prognostic factor for postoperative progress.

Spinal cord ependymomas and the appearance of other de novo tumors: a systematic review.

IntroductionEpendymomas are rare glial tumors of the brain representing less than 5% of brain tumors. However, spinal cord ependymomas in adults account for over 60% of all ependymomas including those arising from the filum terminale and only 40% are intracranial. Reports of the appearance of another neoplasia at a different location in patients with spinal ependymoma are scarce.MethodsWe searched PubMed for studies related to spinal cord ependymomas published over the last 30 years (from January 1984) and retrieved 1197.ResultsWe identified only two studies that met our criteria and we found an incidence of 9% of secondary neoplasias after treatment for spinal ependymoma. The neoplasms were diagnosed from 2 months to 20 years after patients underwent surgery for intraspinal ependymoma. These included pancreatic cancer, prostate cancer, Hodgkin lymphoma, intracranial meningioma, mucin-producing pulmonary adenocarcinoma, gastric cancer and astrocytoma.ConclusionsThe genetic abnormalities affecting patients with spinal ependymomas may indicate a predisposition to the development of secondary cancers or a general failure of the repairing mechanism in their DNA. The unaffected survival rates in those individuals permit for a long period the accumulation of different mutations on the genome and thus the appearance of a second cancer. However, more studies are needed, particularly in young patients with high survival rates.

Rapidly progressive symptom development of pulmonary arterial hypertension: a case report of Trousseau syndrome

Trousseau syndrome is most commonly defined as a hypercoagulability syndrome associated with mucin-producing adenocarcinoma. We report here a rare case of Trousseau syndrome presenting as pulmonary arterial hypertension. The patient complained of cough and increasing exertional dyspnea. Rapidly progressive symptom development of pulmonary arterial hypertension accompanied by right heart failure was observed, and the patient died on hospital day 2. An autopsy revealed Krukenberg tumors on both ovaries and a signet-ring cell gastric carcinoma. In the lungs there was tumor embolism with signet-ring cells to some extent, but the peripheral pulmonary arteries were occupied primarily by pulmonary embolism with platelets, fibroblasts, and fibrotic organized thrombi.

Pancreatic Cyst Prevalence and the Risk of Mucin-Producing Adenocarcinoma in US Adults

The presence of a pancreatic cyst often prompts concern, although the rate of malignant transformation to mucin-producing adenocarcinoma is not known. We aimed to determine the prevalence rate of mucin-producing adenocarcinoma in US adults with pancreatic cysts. This retrospective, population-based cross-sectional study calculated the annual number of mucin-producing adenocarcinomas using the Surveillance Epidemiology and End Results (SEER 18) database and the 2010 US census. The overall prevalence rate of cysts in the population was found using data from large cross-sectional imaging studies of incidental cyst prevalence. Prevalence rates were then calculated by dividing the annual number of mucin-producing adenocarcinomas by the cyst prevalence rate. Between 2005 and 2009, 1,137 mucin-producing adenocarcinomas were estimated to be found annually in a US adult population of 137,154,960. The total number of pancreas cysts, given a cyst prevalence rate of 2.5%, was 3,428,874. Therefore, the prevalence rate of mucin-producing adenocarcinoma arising in patients with pancreatic cysts was 33.2 per 100,000 (95% confidence interval (CI): 21.9-44.5). The prevalence rate was 32.8 per 100,000 (95% CI: 21.6-44.0) in women and 33.5 per 100,000 (95% CI: 22.2-44.8) in men. As expected, the rate of malignant transformation increased linearly with advancing age (highest 38.6 per 100,000 in 80- to 84-year-old men). Malignant transformation of pancreatic cysts into mucin-producing adenocarcinoma in US adults is a very rare event. Current clinical guidelines and resource allocation for pancreatic cyst disease should be reconsidered given these findings.

Primary mucin-producing prostate adenocarcinoma presenting as a gluteal mass. A case report and review of the literature

Primary mucin-producing prostate adenocarcinoma presenting as a gluteal mass. A case report and review of the literature

Tu1229 Pancreatic Cyst Prevalence and the Risk of Mucin-Producing Adenocarcinoma in United States Adults

Tu1229 Pancreatic Cyst Prevalence and the Risk of Mucin-Producing Adenocarcinoma in United States Adults

A Survival Comparison of Mucin-Producing Adenocarcinoma of the Esophagus to Conventional Adenocarcinoma after Esophagectomy

The objective of this study was to test the hypothesis that mucin-producing adenocarcinoma (MA) exhibits a more advanced clinical presentation and worse prognosis than conventional adenocarcinoma (CA) in patients undergoing esophagectomy. Patient demographic and clinical variables and cancer-specific survival were collected from the U.S. Surveillance Epidemiology and End Results database between 1988 and 2006. Esophagectomy was performed for 105 patients with MA and 5473 patients with CA. The MA cohort exhibited a similar age at presentation, gender, and anatomic location (lower third of the esophagus/abdominal) as the CA cohort. We found trends toward advanced pathologic stage of disease of MA compared with CA (Stage IIB to IV 56 vs 46%), higher grade tumors (Grade III/IV, 44 vs 34%), positive lymph nodes (51 vs 40%), and poorer mean survival. For both groups, after multivariate analysis, age at diagnosis, tumor stage, and grade were negative predictors of survival (hazard ratios 1.02, 1.39, and 1.32, respectively; P < 0.001). Although this study suggests that patients with resected MA of the esophagus have a trend toward worse clinical presentation and survival than patients with resected CA, the observations are not significant and do not support our hypothesis or results from single-institution studies.