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Mucinous Cystic Pancreatic Tumor
Siva P. Raman, MD
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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

                                            1. 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
                                            2. Pinho DF et al: Incidental pancreatic cysts: role of magnetic resonance imaging. Top Magn Reson Imaging. 23(2):117-28, 2014
                                            3. Farrell JJ et al: Pancreatic cystic neoplasms: management and unanswered questions. Gastroenterology. 144(6):1303-15, 2013
                                            4. Gil E et al: Mucinous cystic neoplasms of the pancreas with ovarian stroma. ANZ J Surg. 83(12):985-90, 2013
                                            5. Dewhurst CE et al: Cystic tumors of the pancreas: imaging and management. Radiol Clin North Am. 50(3):467-86, 2012
                                            6. 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
                                            7. Kucera JN et al: Cystic lesions of the pancreas: radiologic-endosonographic correlation. Radiographics. 32(7):E283-301, 2012
                                            8. 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
                                            9. 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
                                            10. Bang JY et al: Mucinous cystic neoplasm of the pancreas. Clin Gastroenterol Hepatol. 9(8):e80-1, 2011
                                            11. 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
                                            12. Sakorafas GH et al: Primary pancreatic cystic neoplasms revisited: part II. Mucinous cystic neoplasms. Surg Oncol. 20(2):e93-101, 2011
                                            13. Basturk O et al: Pancreatic cysts: pathologic classification, differential diagnosis, and clinical implications. Arch Pathol Lab Med. 133(3):423-38, 2009
                                            14. 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
                                            15. 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
                                            16. 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
                                            17. Takeshita K et al: Unusual imaging appearances of pancreatic serous cystadenoma: correlation with surgery and pathologic analysis. Abdom Imaging. 30(5):610-5, 2005
                                            18. 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
                                            19. Hara T et al: Mucinous cystic tumors of the pancreas. Surg Today. 32(11):965-9, 2002
                                            20. Maire F et al: Benign inflammatory pancreatic mucinous cystadenomas mimicking locally advanced cystadenocarcinomas. Presentation of 3 cases. Pancreatology. 2(1):74-8, 2002
                                            21. Oshikawa O et al: Dynamic sonography of pancreatic tumors: comparison with dynamic CT. AJR Am J Roentgenol. 178(5):1133-7, 2002
                                            22. Balci NC et al: Radiologic features of cystic, endocrine and other pancreatic neoplasms. Eur J Radiol. 38(2):113-9, 2001
                                            23. Friedman AC et al: CT of primary cystic pancreatic neoplasms: nihilism may be unwarranted. AJR Am J Roentgenol. 177(2):469-70, 2001
                                            24. Grogan JR et al: Making sense of mucin-producing pancreatic tumors. AJR Am J Roentgenol. 176(4):921-9, 2001
                                            25. Megibow AJ et al: Cystic pancreatic masses: cross-sectional imaging observations and serial follow-up. Abdom Imaging. 26(6):640-7, 2001
                                            Related Anatomy
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                                            Related Differential Diagnoses
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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

                                                                                      1. 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
                                                                                      2. Pinho DF et al: Incidental pancreatic cysts: role of magnetic resonance imaging. Top Magn Reson Imaging. 23(2):117-28, 2014
                                                                                      3. Farrell JJ et al: Pancreatic cystic neoplasms: management and unanswered questions. Gastroenterology. 144(6):1303-15, 2013
                                                                                      4. Gil E et al: Mucinous cystic neoplasms of the pancreas with ovarian stroma. ANZ J Surg. 83(12):985-90, 2013
                                                                                      5. Dewhurst CE et al: Cystic tumors of the pancreas: imaging and management. Radiol Clin North Am. 50(3):467-86, 2012
                                                                                      6. 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
                                                                                      7. Kucera JN et al: Cystic lesions of the pancreas: radiologic-endosonographic correlation. Radiographics. 32(7):E283-301, 2012
                                                                                      8. 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
                                                                                      9. 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
                                                                                      10. Bang JY et al: Mucinous cystic neoplasm of the pancreas. Clin Gastroenterol Hepatol. 9(8):e80-1, 2011
                                                                                      11. 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
                                                                                      12. Sakorafas GH et al: Primary pancreatic cystic neoplasms revisited: part II. Mucinous cystic neoplasms. Surg Oncol. 20(2):e93-101, 2011
                                                                                      13. Basturk O et al: Pancreatic cysts: pathologic classification, differential diagnosis, and clinical implications. Arch Pathol Lab Med. 133(3):423-38, 2009
                                                                                      14. 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
                                                                                      15. 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
                                                                                      16. 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
                                                                                      17. Takeshita K et al: Unusual imaging appearances of pancreatic serous cystadenoma: correlation with surgery and pathologic analysis. Abdom Imaging. 30(5):610-5, 2005
                                                                                      18. 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
                                                                                      19. Hara T et al: Mucinous cystic tumors of the pancreas. Surg Today. 32(11):965-9, 2002
                                                                                      20. Maire F et al: Benign inflammatory pancreatic mucinous cystadenomas mimicking locally advanced cystadenocarcinomas. Presentation of 3 cases. Pancreatology. 2(1):74-8, 2002
                                                                                      21. Oshikawa O et al: Dynamic sonography of pancreatic tumors: comparison with dynamic CT. AJR Am J Roentgenol. 178(5):1133-7, 2002
                                                                                      22. Balci NC et al: Radiologic features of cystic, endocrine and other pancreatic neoplasms. Eur J Radiol. 38(2):113-9, 2001
                                                                                      23. Friedman AC et al: CT of primary cystic pancreatic neoplasms: nihilism may be unwarranted. AJR Am J Roentgenol. 177(2):469-70, 2001
                                                                                      24. Grogan JR et al: Making sense of mucin-producing pancreatic tumors. AJR Am J Roentgenol. 176(4):921-9, 2001
                                                                                      25. Megibow AJ et al: Cystic pancreatic masses: cross-sectional imaging observations and serial follow-up. Abdom Imaging. 26(6):640-7, 2001