Mucinous cystic neoplasm (MCN), mucinous macrocystic neoplasm or adenoma, mucinous cystadenoma or cystadenocarcinoma
Definitions
Thick-walled, unilocular or multilocular pancreatic tumor composed of large, mucin-containing cysts
Some sources suggest presence of ovarian stroma within lesion is necessary for diagnosis
MCN and intraductal papillary mucinous neoplasm (IPMN) are together classified as pancreatic mucinous tumors
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Goh BKP et al: Changing trends in the clinicopathological features, practices and outcomes in the surgical management for cystic lesions of the pancreas and impact of the international guidelines: Single institution experience with 462 cases between 1995-2018. Pancreatology. 20(8):1786-90, 2020
Guo Y et al: Sonographic characteristics and follow-up of pancreatic cysts. J Clin Ultrasound. 49(3):184-8, 2020
Mamone G et al: MRI of mucinous pancreatic cystic lesions: a new updated morphological approach for the differential diagnosis. Updates Surg. 72(3):617-37, 2020
Vaalavuo Y et al: The European evidence-based guidelines on pancreatic cystic neoplasms (PCN) in clinical practice: The development of relative and absolute indications for surgery during prospective IPMN surveillance. Pancreatology. 20(7):1393-8, 2020
Yadav RK et al: Differentiating benign from malignant pancreatic cysts on computed tomography. Eur J Radiol Open. 7:100278, 2020
Hasan A et al: Overview and comparison of guidelines for management of pancreatic cystic neoplasms. World J Gastroenterol. 25(31):4405-13, 2019
Elta GH et al: ACG clinical guideline: diagnosis and management of pancreatic cysts. Am J Gastroenterol. 113(4):464-79, 2018
European study group on cystic tumours of the pancreas.: european evidence-based guidelines on pancreatic cystic neoplasms. Gut. 67(5):789-804, 2018
Megibow AJ et al: Management of incidental pancreatic cysts: a white paper of the ACR incidental findings committee. J Am Coll Radiol. 14(7):911-23, 2017
Vege SS et al: American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology. 148(4):819-22; quize12-3, 2015
Park JW et al: Mucinous cystic neoplasm of the pancreas: is surgical resection recommended for all surgically fit patients? Pancreatology. 14(2):131-6, 2014
Pinho DF et al: Incidental pancreatic cysts: role of magnetic resonance imaging. Top Magn Reson Imaging. 23(2):117-28, 2014
Farrell JJ et al: Pancreatic cystic neoplasms: management and unanswered questions. Gastroenterology. 144(6):1303-15, 2013
Gil E et al: Mucinous cystic neoplasms of the pancreas with ovarian stroma. ANZ J Surg. 83(12):985-90, 2013
Dewhurst CE et al: Cystic tumors of the pancreas: imaging and management. Radiol Clin North Am. 50(3):467-86, 2012
Hong SK et al: Targeted cyst wall puncture and aspiration during EUS-FNA increases the diagnostic yield of premalignant and malignant pancreatic cysts. Gastrointest Endosc. 75(4):775-82, 2012
Kucera JN et al: Cystic lesions of the pancreas: radiologic-endosonographic correlation. Radiographics. 32(7):E283-301, 2012
Mottola JC et al: Diffusion-weighted MRI of focal cystic pancreatic lesions at 3.0-Tesla: preliminary results. Abdom Imaging. 37(1):110-7, 2012
Valsangkar NP et al: 851 resected cystic tumors of the pancreas: a 33-year experience at the Massachusetts General Hospital. Surgery. 152(3 Suppl 1):S4-12, 2012
Bang JY et al: Mucinous cystic neoplasm of the pancreas. Clin Gastroenterol Hepatol. 9(8):e80-1, 2011
Le Baleur Y et al: Mucinous cystic neoplasms of the pancreas: definition of preoperative imaging criteria for high-risk lesions. Pancreatology. 11(5):495-9, 2011
Sakorafas GH et al: Primary pancreatic cystic neoplasms revisited: part II. Mucinous cystic neoplasms. Surg Oncol. 20(2):e93-101, 2011
Basturk O et al: Pancreatic cysts: pathologic classification, differential diagnosis, and clinical implications. Arch Pathol Lab Med. 133(3):423-38, 2009
Goh BK et al: A review of mucinous cystic neoplasms of the pancreas defined by ovarian-type stroma: clinicopathological features of 344 patients. World J Surg. 30(12):2236-45, 2006
Goh BK et al: Pancreatic serous oligocystic adenomas: clinicopathologic features and a comparison with serous microcystic adenomas and mucinous cystic neoplasms. World J Surg. 30(8):1553-9, 2006
Kim SY et al: Macrocystic neoplasms of the pancreas: CT differentiation of serous oligocystic adenoma from mucinous cystadenoma and intraductal papillary mucinous tumor. AJR Am J Roentgenol. 187(5):1192-8, 2006
Takeshita K et al: Unusual imaging appearances of pancreatic serous cystadenoma: correlation with surgery and pathologic analysis. Abdom Imaging. 30(5):610-5, 2005
O'Toole D et al: Macrocystic pancreatic cystadenoma: The role of EUS and cyst fluid analysis in distinguishing mucinous and serous lesions. Gastrointest Endosc. 59(7):823-9, 2004
Hara T et al: Mucinous cystic tumors of the pancreas. Surg Today. 32(11):965-9, 2002
Maire F et al: Benign inflammatory pancreatic mucinous cystadenomas mimicking locally advanced cystadenocarcinomas. Presentation of 3 cases. Pancreatology. 2(1):74-8, 2002
Oshikawa O et al: Dynamic sonography of pancreatic tumors: comparison with dynamic CT. AJR Am J Roentgenol. 178(5):1133-7, 2002
Balci NC et al: Radiologic features of cystic, endocrine and other pancreatic neoplasms. Eur J Radiol. 38(2):113-9, 2001
Friedman AC et al: CT of primary cystic pancreatic neoplasms: nihilism may be unwarranted. AJR Am J Roentgenol. 177(2):469-70, 2001
Grogan JR et al: Making sense of mucin-producing pancreatic tumors. AJR Am J Roentgenol. 176(4):921-9, 2001
Megibow AJ et al: Cystic pancreatic masses: cross-sectional imaging observations and serial follow-up. Abdom Imaging. 26(6):640-7, 2001
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
Mucinous cystic neoplasm (MCN), mucinous macrocystic neoplasm or adenoma, mucinous cystadenoma or cystadenocarcinoma
Definitions
Thick-walled, unilocular or multilocular pancreatic tumor composed of large, mucin-containing cysts
Some sources suggest presence of ovarian stroma within lesion is necessary for diagnosis
MCN and intraductal papillary mucinous neoplasm (IPMN) are together classified as pancreatic mucinous tumors
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Goh BKP et al: Changing trends in the clinicopathological features, practices and outcomes in the surgical management for cystic lesions of the pancreas and impact of the international guidelines: Single institution experience with 462 cases between 1995-2018. Pancreatology. 20(8):1786-90, 2020
Guo Y et al: Sonographic characteristics and follow-up of pancreatic cysts. J Clin Ultrasound. 49(3):184-8, 2020
Mamone G et al: MRI of mucinous pancreatic cystic lesions: a new updated morphological approach for the differential diagnosis. Updates Surg. 72(3):617-37, 2020
Vaalavuo Y et al: The European evidence-based guidelines on pancreatic cystic neoplasms (PCN) in clinical practice: The development of relative and absolute indications for surgery during prospective IPMN surveillance. Pancreatology. 20(7):1393-8, 2020
Yadav RK et al: Differentiating benign from malignant pancreatic cysts on computed tomography. Eur J Radiol Open. 7:100278, 2020
Hasan A et al: Overview and comparison of guidelines for management of pancreatic cystic neoplasms. World J Gastroenterol. 25(31):4405-13, 2019
Elta GH et al: ACG clinical guideline: diagnosis and management of pancreatic cysts. Am J Gastroenterol. 113(4):464-79, 2018
European study group on cystic tumours of the pancreas.: european evidence-based guidelines on pancreatic cystic neoplasms. Gut. 67(5):789-804, 2018
Megibow AJ et al: Management of incidental pancreatic cysts: a white paper of the ACR incidental findings committee. J Am Coll Radiol. 14(7):911-23, 2017
Vege SS et al: American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology. 148(4):819-22; quize12-3, 2015
Park JW et al: Mucinous cystic neoplasm of the pancreas: is surgical resection recommended for all surgically fit patients? Pancreatology. 14(2):131-6, 2014
Pinho DF et al: Incidental pancreatic cysts: role of magnetic resonance imaging. Top Magn Reson Imaging. 23(2):117-28, 2014
Farrell JJ et al: Pancreatic cystic neoplasms: management and unanswered questions. Gastroenterology. 144(6):1303-15, 2013
Gil E et al: Mucinous cystic neoplasms of the pancreas with ovarian stroma. ANZ J Surg. 83(12):985-90, 2013
Dewhurst CE et al: Cystic tumors of the pancreas: imaging and management. Radiol Clin North Am. 50(3):467-86, 2012
Hong SK et al: Targeted cyst wall puncture and aspiration during EUS-FNA increases the diagnostic yield of premalignant and malignant pancreatic cysts. Gastrointest Endosc. 75(4):775-82, 2012
Kucera JN et al: Cystic lesions of the pancreas: radiologic-endosonographic correlation. Radiographics. 32(7):E283-301, 2012
Mottola JC et al: Diffusion-weighted MRI of focal cystic pancreatic lesions at 3.0-Tesla: preliminary results. Abdom Imaging. 37(1):110-7, 2012
Valsangkar NP et al: 851 resected cystic tumors of the pancreas: a 33-year experience at the Massachusetts General Hospital. Surgery. 152(3 Suppl 1):S4-12, 2012
Bang JY et al: Mucinous cystic neoplasm of the pancreas. Clin Gastroenterol Hepatol. 9(8):e80-1, 2011
Le Baleur Y et al: Mucinous cystic neoplasms of the pancreas: definition of preoperative imaging criteria for high-risk lesions. Pancreatology. 11(5):495-9, 2011
Sakorafas GH et al: Primary pancreatic cystic neoplasms revisited: part II. Mucinous cystic neoplasms. Surg Oncol. 20(2):e93-101, 2011
Basturk O et al: Pancreatic cysts: pathologic classification, differential diagnosis, and clinical implications. Arch Pathol Lab Med. 133(3):423-38, 2009
Goh BK et al: A review of mucinous cystic neoplasms of the pancreas defined by ovarian-type stroma: clinicopathological features of 344 patients. World J Surg. 30(12):2236-45, 2006
Goh BK et al: Pancreatic serous oligocystic adenomas: clinicopathologic features and a comparison with serous microcystic adenomas and mucinous cystic neoplasms. World J Surg. 30(8):1553-9, 2006
Kim SY et al: Macrocystic neoplasms of the pancreas: CT differentiation of serous oligocystic adenoma from mucinous cystadenoma and intraductal papillary mucinous tumor. AJR Am J Roentgenol. 187(5):1192-8, 2006
Takeshita K et al: Unusual imaging appearances of pancreatic serous cystadenoma: correlation with surgery and pathologic analysis. Abdom Imaging. 30(5):610-5, 2005
O'Toole D et al: Macrocystic pancreatic cystadenoma: The role of EUS and cyst fluid analysis in distinguishing mucinous and serous lesions. Gastrointest Endosc. 59(7):823-9, 2004
Hara T et al: Mucinous cystic tumors of the pancreas. Surg Today. 32(11):965-9, 2002
Maire F et al: Benign inflammatory pancreatic mucinous cystadenomas mimicking locally advanced cystadenocarcinomas. Presentation of 3 cases. Pancreatology. 2(1):74-8, 2002
Oshikawa O et al: Dynamic sonography of pancreatic tumors: comparison with dynamic CT. AJR Am J Roentgenol. 178(5):1133-7, 2002
Balci NC et al: Radiologic features of cystic, endocrine and other pancreatic neoplasms. Eur J Radiol. 38(2):113-9, 2001
Friedman AC et al: CT of primary cystic pancreatic neoplasms: nihilism may be unwarranted. AJR Am J Roentgenol. 177(2):469-70, 2001
Grogan JR et al: Making sense of mucin-producing pancreatic tumors. AJR Am J Roentgenol. 176(4):921-9, 2001
Megibow AJ et al: Cystic pancreatic masses: cross-sectional imaging observations and serial follow-up. Abdom Imaging. 26(6):640-7, 2001
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