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Archives of Pathology & Laboratory... Oct 2011Appendiceal mucinous neoplasms are considered enigmatic tumors of unpredictable biologic potential. Their importance lies in their potential to spread to the peritoneum... (Review)
Review
CONTEXT
Appendiceal mucinous neoplasms are considered enigmatic tumors of unpredictable biologic potential. Their importance lies in their potential to spread to the peritoneum and viscera in the form of gelatinous mucin deposits. Extra-appendiceal spread of these tumors is the most common etiology of pseudomyxoma peritonei , which is a descriptive term encompassing a number of neoplastic and nonneoplastic peritoneal disorders. Many studies aimed at evaluating the biologic importance of appendiceal mucinous neoplasms and pseudomyxoma peritonei have employed inconsistent histologic criteria for their diagnosis and descriptive terminology for their classification. As a result, appendiceal mucinous neoplasms and associated peritoneal disease represents one of the most confusing and controversial areas in gastrointestinal pathology.
OBJECTIVES
To summarize the literature regarding the biologic potential of appendiceal mucinous neoplasms and pseudomyxoma peritonei and to discuss the similarities and differences between proposed systems for their classification.
DATA SOURCES
Literature review and case-derived material.
CONCLUSIONS
Many studies have contributed to an increased understanding of the natural progression of mucinous neoplasms of the appendix and peritoneum, and the adoption of a uniform reporting system, as advocated by the American Joint Committee on Cancer and the World Health Organization, will facilitate clear communication among pathologists and clinical colleagues.
Topics: Adenocarcinoma, Mucinous; Appendiceal Neoplasms; Female; Humans; Male; Mucins; Neoplasms, Cystic, Mucinous, and Serous; Peritoneal Neoplasms; Pseudomyxoma Peritonei
PubMed: 21970481
DOI: 10.5858/arpa.2011-0034-RA -
World Journal of Surgical Oncology Feb 2024Invasive mucinous adenocarcinoma of the lung (IMA) is a unique and rare subtype of lung adenocarcinoma with poorly defined prognostic factors and highly controversial... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Invasive mucinous adenocarcinoma of the lung (IMA) is a unique and rare subtype of lung adenocarcinoma with poorly defined prognostic factors and highly controversial studies. Hence, this study aimed to comprehensively identify and summarize the prognostic factors associated with IMA.
METHODS
A comprehensive search of relevant literature was conducted in the PubMed, Embase, Cochrane, and Web of Science databases from their inception until June 2023. The pooled hazard ratio (HR) and corresponding 95% confidence intervals (CI) of overall survival (OS) and/or disease-free survival (DFS) were obtained to evaluate potential prognostic factors.
RESULTS
A total of 1062 patients from 11 studies were included. In univariate analysis, we found that gender, age, TNM stage, smoking history, lymph node metastasis, pleural metastasis, spread through air spaces (STAS), tumor size, pathological grade, computed tomography (CT) findings of consolidative-type morphology, pneumonia type, and well-defined heterogeneous ground-glass opacity (GGO) were risk factors for IMA, and spiculated margin sign was a protective factor. In multivariate analysis, smoking history, lymph node metastasis, pathological grade, STAS, tumor size, and pneumonia type sign were found to be risk factors. There was not enough evidence that epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) mutations, CT signs of lobulated margin, and air bronchogram were related to the prognosis for IMA.
CONCLUSION
In this study, we comprehensively analyzed prognostic factors for invasive mucinous adenocarcinoma of the lung in univariate and multivariate analyses of OS and/or DFS. Finally, 12 risk factors and 1 protective factor were identified. These findings may help guide the clinical management of patients with invasive mucinous adenocarcinoma of the lung.
Topics: Humans; Adenocarcinoma of Lung; Adenocarcinoma, Mucinous; Lung; Lung Neoplasms; Lymphatic Metastasis; Neoplasm Staging; Pneumonia; Prognosis; Retrospective Studies; Male; Female
PubMed: 38303008
DOI: 10.1186/s12957-024-03326-4 -
Journal of Veterinary Diagnostic... Nov 2022An 18-y-old female tufted deer () had a short history of chronic diarrhea, progressive weight loss, and hindlimb instability. Given the poor prognosis, the deer was... (Review)
Review
An 18-y-old female tufted deer () had a short history of chronic diarrhea, progressive weight loss, and hindlimb instability. Given the poor prognosis, the deer was euthanized and submitted for postmortem examination. The most significant gross finding was segmental and multinodular mural thickening of the proximal colon. On cut surface of the affected colonic segments, 0.5-2-cm diameter, intramural, multiloculated, cystic structures containing gray, translucent, gelatinous material elevated the edematous mucosa. Microscopically, the intramural cystic structures were filled with mucinous matrix admixed with foamy macrophages, and lined by discontinuous segments of well-differentiated columnar, pancytokeratin-positive epithelium with basilar nuclei. Multifocally, transition was observed from hyperplastic mucosal crypt epithelium to dysplastic or neoplastic columnar and flattened epithelium lining submucosal and serosal cysts. Cyst lumina were irregularly disrupted by polypoid ingrowths of collagenous tissue covered by attenuated epithelium. Based on these findings, we diagnosed a well-differentiated mucinous adenocarcinoma. Although intestinal adenocarcinomas have been described in humans and animals, they are considered uncommon in most domestic species, except for sheep, for which genetic and environmental factors appear to influence occurrence. Our report addresses the knowledge gap regarding intestinal adenocarcinomas affecting cervids and specifically the tufted deer, a less-studied, near-threatened Asian cervid.
Topics: Humans; Animals; Female; Sheep; Deer; Diagnosis, Differential; Colon; Cysts; Adenocarcinoma; Adenocarcinoma, Mucinous; Sheep Diseases
PubMed: 36056527
DOI: 10.1177/10406387221123007 -
Asian Journal of Surgery Jan 2023Gallbladder mucinous adenocarcinoma (GBMAC) is a rare type of gallbladder malignant tumor, whereas little is known regarding the clinicopathological features and...
BACKGROUND
Gallbladder mucinous adenocarcinoma (GBMAC) is a rare type of gallbladder malignant tumor, whereas little is known regarding the clinicopathological features and surgical outcomes of GBMAC.
METHODS
From January 2000 till December 2015, 54 GBMAC patients who underwent curative-intent surgical resection at our institution were retrospectively reviewed. We compared the clinicopathological features and surgical outcomes of these GBMAC patients with a relatively large cohort of surgically resected conventional gallbladder adenocarcinoma (GBAC) patients without existence of mucinous components.
RESULTS
The clinicopathological features of GBMAC were significantly different from conventional GBAC, including poorer tumor differentiation (P < 0.001), higher CA19-9 levels (P < 0.001), larger tumor sizes (P = 0.020), advanced AJCC tumor stage (P = 0.002), higher frequency of liver parenchyma invasion (P = 0.020), portal vein invasion (P = 0.003), lymph node metastasis (P = 0.016), lympho-vascular invasion (P < 0.001) and perineural invasion (P = 0.025). Relative to conventional GBAC patients, GBMAC patients showed significantly worse overall survival (OS) (29.0 vs 15.0 months; P < 0.001). Multivariate analysis confirmed the surgical margin (P = 0.046), tumor differentiation grade (P = 0.018), lymph node metastasis (P = 0.024), and presence of signet-ring cell component (P = 0.005) as independent prognostic factors influencing OS of patients with GBMAC.
CONCLUSION
GBMAC always had more aggressive biological behaviors and poor survival outcomes even after curative surgery. GBMAC patients with the presence of signet-ring cell component showed even worse survival outcome.
Topics: Humans; Lymphatic Metastasis; Retrospective Studies; Adenocarcinoma, Mucinous; Adenocarcinoma; Gallbladder Neoplasms; Carcinoma, Signet Ring Cell; Prognosis; Neoplasm Staging
PubMed: 35422386
DOI: 10.1016/j.asjsur.2022.03.094 -
Archives of Pathology & Laboratory... Jan 2023Mucinous lesions of the breast encompass many entities ranging from benign to malignant and nonneoplastic to neoplastic. Lesions discussed under this category are... (Review)
Review
CONTEXT.—
Mucinous lesions of the breast encompass many entities ranging from benign to malignant and nonneoplastic to neoplastic. Lesions discussed under this category are mucocele-like lesion, mucinous carcinoma, mucinous micropapillary carcinoma, solid papillary carcinoma, mucinous cystadenocarcinoma, mucoepidermoid carcinoma, invasive lobular carcinoma with extracellular mucin, mucinous ductal carcinoma in situ, and metastasis.
OBJECTIVE.—
To review clinical, pathologic, and molecular features of mucinous lesions of the breast, their differential diagnoses, and challenging features on core needle biopsies.
DATA SOURCES.—
The existing scientific and clinical literature as of December 2021.
CONCLUSIONS.—
The category of mucinous lesions of the breast is vast and the differential diagnosis can be challenging, especially on core needle biopsies. In all cases, clinical, radiologic, and pathologic correlation is necessary to reach a comprehensive diagnosis. Given that the prognosis and management of each entity is different, being aware of these entities and their nuances is critical for a pathologist to guide accurate management.
Topics: Female; Humans; Adenocarcinoma, Mucinous; Biopsy, Large-Core Needle; Breast; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating
PubMed: 36577093
DOI: 10.5858/arpa.2022-0054-RA -
BMC Pulmonary Medicine Jan 2023In 2015, the World Health Organization renamed mucinous bronchioloalveolar adenocarcinoma as pulmonary invasive mucinous adenocarcinoma (IMA). Due to its low incidence...
PURPOSE
In 2015, the World Health Organization renamed mucinous bronchioloalveolar adenocarcinoma as pulmonary invasive mucinous adenocarcinoma (IMA). Due to its low incidence and unclear prognosis with surgical treatment, previous studies have presented opposing survival outcomes. We aimed to investigate the differences in surgical prognosis and prognosis-related risk factors by comparing IMA with non-mucinous invasive adenocarcinoma (NMA).
METHODS
A total of 20,914 patients diagnosed with IMA or NMA from 2000 to 2014 were screened from the Surveillance, Epidemiology, and End Results database. The screened patients were subjected to propensity score matching (PSM) in a 1:4 ratio to explore the survival differences between patients with IMA and NMA and the factors influencing prognosis.
RESULTS
For all patients, IMA was prevalent in the lower lobes of the lungs (p < 0.0001), well-differentiated histologically (p < 0.0001), less likely to have lymph node metastases (94.4% vs. 72.0%, p < 0.0001) and at an earlier pathological stage (p = 0.0001). After PSM, the IMA cohort consisted of 303 patients, and the NMA cohort consisted of 1212 patients. Kaplan‒Meier survival analysis showed no difference in overall survival (OS) between patients in the IMA cohort and those in the NMA cohort (p = 0.7). Cox proportional hazards analysis showed that differences in tumor pathological type did not influence OS between the two cohorts (p = 0.65). Age (HR: 1.98, 95% CI 1.7-2.31, p < 0.0001), gender (HR: 0.64, 95% CI 0.55-0.75, p < 0.0001), and radiation treatment (HR: 2.49, 95% CI 1.84-3.37, p < 0.0001) were independent predictors of patient OS.
CONCLUSION
There was no significant difference in OS between patients with IMA and those with NMA after surgical treatment. Age, sex, and radiation treatment can independently predict OS.
Topics: Humans; Adenocarcinoma; Adenocarcinoma of Lung; Adenocarcinoma, Mucinous; Prognosis; Lung Neoplasms; Lung; Neoplasm Staging; Retrospective Studies
PubMed: 36624430
DOI: 10.1186/s12890-023-02305-x -
Archives of Pathology & Laboratory... Jan 2020Mucinous tubular and spindle cell carcinomas are rare kidney tumors with generally indolent behavior. As the name suggests, classic histomorphology reveals bland spindle... (Review)
Review
Mucinous tubular and spindle cell carcinomas are rare kidney tumors with generally indolent behavior. As the name suggests, classic histomorphology reveals bland spindle cells, tubules, and mucinous stroma. Uncommon histologic features include mucin-poor stroma, high nuclear grade, cellular pleomorphism, and presence of necrosis. Rare cases can show aggressive growth and distant metastasis. Mucinous tubular and spindle cell carcinoma has characteristic chromosomal abnormalities and the molecular signature remains the same, irrespective of the varied histomorphology.
Topics: Adenocarcinoma, Mucinous; Carcinoma, Renal Cell; Humans; Kidney Neoplasms; Prognosis
PubMed: 30865490
DOI: 10.5858/arpa.2017-0506-RS -
Thoracic Cancer Dec 2020Invasive mucinous adenocarcinoma (IMA) of the lung is a rare and distinct subtype of adenocarcinoma that can appear as airspace opacities on computed tomography (CT). In...
BACKGROUND
Invasive mucinous adenocarcinoma (IMA) of the lung is a rare and distinct subtype of adenocarcinoma that can appear as airspace opacities on computed tomography (CT). In daily practice, we have occasionally encountered spontaneous regression of airspace opacities (SRAs) without treatment on serial CTs in patients with IMAs, which has not previously been described in the literature. Here, we describe serial CT findings with emphasis on SRAs in relation to clinicopathological features and treatment outcomes in patients with IMAs.
METHODS
A total of 46 patients with pathologically-confirmed IMAs of the lung from January 2013 to June 2018 were included. Serial CT scans were reviewed and the patients were classified into SRA and no-SRA groups according to the presence of SRA. Radiological features, clinicopathological characteristics, and treatment outcomes were compared between the SRA and no-SRA groups.
RESULTS
A total of 32 patients were included in the no-SRA group and 14 patients in the SRA group. IMAs in the SRA group were mostly pneumonic (P < 0.001), larger (P < 0.001), multifocal (P = 0.001), and showed higher stage (P < 0.001) on initial CT. Of seven patients who died during follow-up, six were from the SRA group (P < 0.001). Mean overall survival for all IMAs was 86.6 months (range, 0-110 months), and the SRA group showed significantly worse overall survival (P < 0.001).
CONCLUSIONS
IMAs of the lung showing SRAs on serial CTs are larger and multifocal, and tend to be pneumonic in type on initial CT. Patients present at a higher stage of disease, with higher mortality rate and reduced overall survival.
KEY POINTS
SIGNIFICANT FINDINGS OF THE STUDY: Invasive mucinous adenocarcinomas (IMAs) of the lung can show spontaneous regression of airspace opacities (SRAs) on serial CTs, without being correlated to the administration of anticancer drugs. IMAs that showed SRAs demonstrated reduced overall survival in patients.
WHAT THIS STUDY ADDS
When airspace opacities show regression on CT, IMA should still be included in the differential diagnosis. A more careful application of RECIST 1.1 is needed in the assessment of tumor response of IMAs.
Topics: Adenocarcinoma, Mucinous; Aged; Humans; Lung Neoplasms; Male; Survival Analysis; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 33021074
DOI: 10.1111/1759-7714.13674 -
International Journal of Molecular... May 2018Ovarian mucinous tumors represent a group of rare neoplasms with a still undefined cell of origin but with an apparent progression from benign to borderline to... (Review)
Review
Ovarian mucinous tumors represent a group of rare neoplasms with a still undefined cell of origin but with an apparent progression from benign to borderline to carcinoma. Even though these tumors are different from the other histological subtypes of epithelial ovarian neoplasms, they are still treated with a similar chemotherapeutic approach. Here, we review its pathogenesis, molecular alterations, (differential) diagnosis, clinical presentation and current treatment, and how recent molecular and biological information on this tumor might lead to better and more specific clinical management of patients with mucinous ovarian carcinoma.
Topics: Adenocarcinoma, Mucinous; Female; Humans; Ovarian Neoplasms
PubMed: 29795040
DOI: 10.3390/ijms19061569 -
Cancer Treatment and Research... 2022Mucinous adenocarcinoma is a rare subtype of lung cancer characterized by abnormal mucin production. We sought to investigate the clinical and pathological features of...
BACKGROUND
Mucinous adenocarcinoma is a rare subtype of lung cancer characterized by abnormal mucin production. We sought to investigate the clinical and pathological features of pulmonary mucinous adenocarcinomas and to identify prognostic factors.
METHODS
This was a single-institution retrospective review of patients with pulmonary mucinous adenocarcinoma diagnosed between January 1, 2015 and December 31, 2020. Descriptive analysis included demographics, diagnostic data, and treatment modalities. The primary outcome was overall survival (OS).
RESULTS
Fifty-six patients were included in the study. Median age was 65 years (range: 26-84), 30 (54%) were female, 48 (86%) had a smoking history, and 41 (73%) patients had ECOG performance status 0-1. Nearly half (26, 46%) were stage IV at presentation, while 11 (20%) presented as stage I, 10 (18%) stage II, and 9 (16%) stage III. Biomarker testing increased through the study period. Where performed, 4/48 (8%) cases were ALK positive, but there were no EGFR cases identified (0/36). Only 3/20 cases had PD-L1 expression >50%. Curative intent therapy was performed in 23 patients (17 had surgery +/- chemotherapy/radiation, 4 had radiotherapy alone, 2 had chemoradiation). Median OS in the entire population was 16.1 months (m). OS by stage was 50.0m for stage I, not reached for stage II, 20.7m for stage III, and 8.1m for stage IV.
CONCLUSIONS
The overall prognosis of pulmonary mucinous adenocarcinoma appears similar to that of non-mucinous adenocarcinomas, with distinct differences noted in the incidence of oncogenic driver mutations, particularly an absence of EGFR mutations.
Topics: Adenocarcinoma; Adenocarcinoma of Lung; Adenocarcinoma, Mucinous; Aged; ErbB Receptors; Female; Humans; Lung Neoplasms; Male
PubMed: 35523040
DOI: 10.1016/j.ctarc.2022.100570