Cargando…

Simple mucinous cyst: another potential cancer precursor in the pancreas? Case report with molecular characterization and systematic review of the literature

Cystic lesions of the pancreas may range from benign to precursors of pancreatic cancer. Simple mucinous cyst (SMC) is larger than 1 cm, has a gastric-type flat mucinous lining, and minimal atypia without ovarian-type stroma. We report a new case of pancreatic SMC, coupling a systematic review of th...

Descripción completa

Detalles Bibliográficos
Autores principales: Milanetto, Anna Caterina, Tonello, Alice Sabrina, Valotto, Giovanni, Munari, Giada, Luchini, Claudio, Fassan, Matteo, Pasquali, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298240/
https://www.ncbi.nlm.nih.gov/pubmed/33511431
http://dx.doi.org/10.1007/s00428-021-03029-1
_version_ 1783726023571931136
author Milanetto, Anna Caterina
Tonello, Alice Sabrina
Valotto, Giovanni
Munari, Giada
Luchini, Claudio
Fassan, Matteo
Pasquali, Claudio
author_facet Milanetto, Anna Caterina
Tonello, Alice Sabrina
Valotto, Giovanni
Munari, Giada
Luchini, Claudio
Fassan, Matteo
Pasquali, Claudio
author_sort Milanetto, Anna Caterina
collection PubMed
description Cystic lesions of the pancreas may range from benign to precursors of pancreatic cancer. Simple mucinous cyst (SMC) is larger than 1 cm, has a gastric-type flat mucinous lining, and minimal atypia without ovarian-type stroma. We report a new case of pancreatic SMC, coupling a systematic review of the English literature mainly focused on their clinic-pathological features. We reviewed 103 cases of SMC in adults (73 women), averaging 57 (range, 26–70) years. The SMCs were located in the body-tail region of the pancreas in 60 (58%) cases, presenting as single cystic lesions in 94% of cases; 43% of patients were asymptomatic. A preoperative fine-needle aspiration of the cyst fluid detected amylase and carcinoembryonic antigen positivity in 71% and 76% of cases, respectively. Patients underwent surgery mostly for suspected malignancy; in 83% of cases, a standard pancreatic resection was performed. Mean SMC size was 4.9 (range, 1.5–12.0) cm. Mucins MUC5AC and MUC6 resulted positive in 77% and 81% of cases performed, respectively, whereas MUC2 was negative in all but one patient. The SMC from our institution was characterized by a KRAS somatic mutation. The diagnosis of SMC should be considered when a solitary pancreatic cyst larger than 1 cm is detected in asymptomatic patients. To establish a correct diagnosis, an extensive histologic/immunohistochemical analysis is essential. The presence of a KRAS mutation highlights that SMC may represent another potential pancreatic cancer precursor.
format Online
Article
Text
id pubmed-8298240
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-82982402021-07-23 Simple mucinous cyst: another potential cancer precursor in the pancreas? Case report with molecular characterization and systematic review of the literature Milanetto, Anna Caterina Tonello, Alice Sabrina Valotto, Giovanni Munari, Giada Luchini, Claudio Fassan, Matteo Pasquali, Claudio Virchows Arch Original Article Cystic lesions of the pancreas may range from benign to precursors of pancreatic cancer. Simple mucinous cyst (SMC) is larger than 1 cm, has a gastric-type flat mucinous lining, and minimal atypia without ovarian-type stroma. We report a new case of pancreatic SMC, coupling a systematic review of the English literature mainly focused on their clinic-pathological features. We reviewed 103 cases of SMC in adults (73 women), averaging 57 (range, 26–70) years. The SMCs were located in the body-tail region of the pancreas in 60 (58%) cases, presenting as single cystic lesions in 94% of cases; 43% of patients were asymptomatic. A preoperative fine-needle aspiration of the cyst fluid detected amylase and carcinoembryonic antigen positivity in 71% and 76% of cases, respectively. Patients underwent surgery mostly for suspected malignancy; in 83% of cases, a standard pancreatic resection was performed. Mean SMC size was 4.9 (range, 1.5–12.0) cm. Mucins MUC5AC and MUC6 resulted positive in 77% and 81% of cases performed, respectively, whereas MUC2 was negative in all but one patient. The SMC from our institution was characterized by a KRAS somatic mutation. The diagnosis of SMC should be considered when a solitary pancreatic cyst larger than 1 cm is detected in asymptomatic patients. To establish a correct diagnosis, an extensive histologic/immunohistochemical analysis is essential. The presence of a KRAS mutation highlights that SMC may represent another potential pancreatic cancer precursor. Springer Berlin Heidelberg 2021-01-28 2021 /pmc/articles/PMC8298240/ /pubmed/33511431 http://dx.doi.org/10.1007/s00428-021-03029-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Milanetto, Anna Caterina
Tonello, Alice Sabrina
Valotto, Giovanni
Munari, Giada
Luchini, Claudio
Fassan, Matteo
Pasquali, Claudio
Simple mucinous cyst: another potential cancer precursor in the pancreas? Case report with molecular characterization and systematic review of the literature
title Simple mucinous cyst: another potential cancer precursor in the pancreas? Case report with molecular characterization and systematic review of the literature
title_full Simple mucinous cyst: another potential cancer precursor in the pancreas? Case report with molecular characterization and systematic review of the literature
title_fullStr Simple mucinous cyst: another potential cancer precursor in the pancreas? Case report with molecular characterization and systematic review of the literature
title_full_unstemmed Simple mucinous cyst: another potential cancer precursor in the pancreas? Case report with molecular characterization and systematic review of the literature
title_short Simple mucinous cyst: another potential cancer precursor in the pancreas? Case report with molecular characterization and systematic review of the literature
title_sort simple mucinous cyst: another potential cancer precursor in the pancreas? case report with molecular characterization and systematic review of the literature
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298240/
https://www.ncbi.nlm.nih.gov/pubmed/33511431
http://dx.doi.org/10.1007/s00428-021-03029-1
work_keys_str_mv AT milanettoannacaterina simplemucinouscystanotherpotentialcancerprecursorinthepancreascasereportwithmolecularcharacterizationandsystematicreviewoftheliterature
AT tonelloalicesabrina simplemucinouscystanotherpotentialcancerprecursorinthepancreascasereportwithmolecularcharacterizationandsystematicreviewoftheliterature
AT valottogiovanni simplemucinouscystanotherpotentialcancerprecursorinthepancreascasereportwithmolecularcharacterizationandsystematicreviewoftheliterature
AT munarigiada simplemucinouscystanotherpotentialcancerprecursorinthepancreascasereportwithmolecularcharacterizationandsystematicreviewoftheliterature
AT luchiniclaudio simplemucinouscystanotherpotentialcancerprecursorinthepancreascasereportwithmolecularcharacterizationandsystematicreviewoftheliterature
AT fassanmatteo simplemucinouscystanotherpotentialcancerprecursorinthepancreascasereportwithmolecularcharacterizationandsystematicreviewoftheliterature
AT pasqualiclaudio simplemucinouscystanotherpotentialcancerprecursorinthepancreascasereportwithmolecularcharacterizationandsystematicreviewoftheliterature