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Joldoshova A, Belousova T, Cai Z, Billah S. Primary retroperitoneal mucinous cystic neoplasm leading to multifocal invasive adenocarcinoma of the small and large intestine. HUMAN PATHOLOGY: CASE REPORTS 2020. [DOI: 10.1016/j.ehpc.2020.200419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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2
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Tomisaki I, Matsuyama A, Jotatsu M, Yamamura S, Onishi R, Fujimoto N. Primary retroperitoneal mucinous cystadenocarcinoma with transition from the mesothelium. IJU Case Rep 2020; 3:137-140. [PMID: 33392473 PMCID: PMC7770595 DOI: 10.1002/iju5.12169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Mucinous cystic neoplasms are uncommon among the tumors that develop in the retroperitoneum. We report a case of primary retroperitoneal mucinous cystadenocarcinoma with pathological considerations. CASE PRESENTATION A 47-year-old woman complaining of abdominal discomfort presented at our hospital. Abdominal computed tomography and magnetic resonance imaging showed a large cystic tumor with small solid nodules located in the right retroperitoneum. The tumor was completely removed and the microscopic findings were consistent with primary retroperitoneal mucinous cystadenocarcinoma. Two years after the surgery, the patient is alive without recurrence of the tumor. CONCLUSION The microscopic findings suggested that the primary retroperitoneal mucinous cystadenocarcinoma developed from the metaplasia of the remnant coelomic epithelium. A complete tumor resection that includes the adjacent peritoneum is important to prevent local recurrence.
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Affiliation(s)
- Ikko Tomisaki
- Department ofUrologySchool of MedicineUniversity of Occupational and Environmental HealthKitakyushuFukuokaJapan
| | - Atsuji Matsuyama
- Department ofPathology and OncologySchool of MedicineUniversity of Occupational and Environmental HealthKitakyushuFukuokaJapan
| | - Mao Jotatsu
- Department ofPathology and OncologySchool of MedicineUniversity of Occupational and Environmental HealthKitakyushuFukuokaJapan
| | - Sohei Yamamura
- Department ofUrologySchool of MedicineUniversity of Occupational and Environmental HealthKitakyushuFukuokaJapan
| | - Rei Onishi
- Department ofUrologySchool of MedicineUniversity of Occupational and Environmental HealthKitakyushuFukuokaJapan
| | - Naohiro Fujimoto
- Department ofUrologySchool of MedicineUniversity of Occupational and Environmental HealthKitakyushuFukuokaJapan
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Hegazi TM, Al-Sharydah AM, Lee KS, Mortele K. Retroperitoneal cystic masses: magnetic resonance imaging features. Abdom Radiol (NY) 2020; 45:499-511. [PMID: 31583446 DOI: 10.1007/s00261-019-02246-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The objective of this review is to discuss the clinical and histopathologic features, MRI characteristics, and management options of retroperitoneal cystic masses. Radiologists should be familiar with the MR imaging characteristics of retroperitoneal cystic masses to allow for a refined differential diagnosis, assist with lesion management, and prevent unnecessary invasive procedures.
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Affiliation(s)
- Tarek M Hegazi
- Department of Radiology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | | | - Karen S Lee
- Division of Abdominal Imaging/Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Koenraad Mortele
- Division of Abdominal Imaging/Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
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Tokai H, Nagata Y, Taniguchi K, Matsumura N, Kitasato A, Tokunaga T, Takeshita H, Kuroki T, Maeda S, Ito M, Fujioka H. The long-term survival in primary retroperitoneal mucinous cystadenocarcinoma: a case report. Surg Case Rep 2017; 3:117. [PMID: 29177806 PMCID: PMC5702287 DOI: 10.1186/s40792-017-0394-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/15/2017] [Indexed: 12/16/2022] Open
Abstract
Background Primary retroperitoneal mucinous cystadenocarcinoma (PRMC) is extremely rare, and its biological behavior, pathogenesis, optimum treatments, and prognosis remain to be elucidated. We herein report a case of PRMC with an 80-month follow-up. Case presentation A 29-year-old woman was diagnosed with unknown retroperitoneal tumor with benign right ovarian cyst and uterine fibroids, and she underwent laparotomy. The tumor was completely resected with a subsequent histopathological diagnosis of primary retroperitoneal mucinous cystadenocarcinoma (PRMC). Eighty months after surgery, she remains recurrence-free. Conclusion PRMC is an extremely rare tumor. Only around 60 cases have so far been published in the literature. The preoperative diagnosis of PRMC is difficult, and a definitive diagnosis can usually only be made based on the findings of histopathological examinations after surgery. Presently, only radical resection is useful for both diagnostic and therapeutic purposes. The optimal long-term management after surgery is still not well established. Further studies on PRMC are therefore needed to elucidate the etiology and establish effective treatments.
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Affiliation(s)
- Hirotaka Tokai
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.
| | - Yasuhiro Nagata
- Center for Comprehensive Community Care Education Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ken Taniguchi
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Naomi Matsumura
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Amane Kitasato
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Takayuki Tokunaga
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Hiroaki Takeshita
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Tamotsu Kuroki
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Shigeto Maeda
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Masahiro Ito
- Department of pathology, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Hikaru Fujioka
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
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Pellegrino B, Sikokis A, Bersanelli M, Leonetti A, Leonardi F, Di Meglio G, Buti S. Primary Retroperitoneal Cystoadenocarcinoma: A Systematic Review. Gynecol Obstet Invest 2016; 81:385-93. [DOI: 10.1159/000446954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/16/2016] [Indexed: 11/19/2022]
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Myriokefalitaki E, Luqman I, Potdar N, Brown L, Steward W, Moss EL. Primary retroperitoneal mucinous cystadenocarcinoma (PRMCa): a systematic review of the literature and meta-analysis. Arch Gynecol Obstet 2015; 293:709-20. [PMID: 26681306 DOI: 10.1007/s00404-015-3975-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 11/24/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Primary retroperitoneal mucinous cystadenocarcinoma (PRMCa) is a rare tumour. Prognosis and optimal management are not well established. In view of a case managed in our Centre, we performed a systematic review and meta-analysis. METHOD Systematic review of medical electronic databases for published data (1950-12/10/2015). No RCTs identified. Individual patient data detracted from case reports and case series were analysed RESULTS In total, 73 female and 5 male cases of PRMCa identified including our case. Median age at diagnosis was 42.0 years (range 18-86 years), with women being significantly younger than men at diagnosis (42.0 years versus 62.2 years, p = 0.005). A palpable abdominal mass and abdominal pain were the most common presentations in 42.9 and 23.8 % of cases, respectively. Twenty-six women were <38 years old. There were 16 women <38 years old that had surgical data reported, of which 14 underwent fertility-sparing surgery with excision of the mass. Adjuvant chemotherapy was given in 24.1 % (13/72) women. Follow-up ranged from 1 to 130 months with a median of 15 months. Of the 57 cases that had follow-up reported, recurrence occurred in 23 cases (40.4 %) within a median of 8 months from diagnosis. Median disease-free survival was 15 months (range 1-130 months). Of the women who recurred, 14 died of their disease giving 1, 2 and 5-year disease-specific survival rates of 85.9, 80.7 and 75.4 %, respectively. CONCLUSION PRMCa are rare and potentially aggressive tumours that often occur in young women. Removal of the tumour, adequate staging and adjuvant chemotherapy needs to be considered.
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Affiliation(s)
- E Myriokefalitaki
- Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK.
| | - I Luqman
- Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK
| | - N Potdar
- Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK
| | - L Brown
- Department of Pathology, University Hospitals of Leicester, Leicester, UK
| | - W Steward
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| | - E L Moss
- Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK.,Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
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Lee SE, Oh HC, Park YG, Choi YS, Kim MK. Laparoscopic excision of primary retroperitoneal mucinous cystadenoma and malignant predicting factors derived from literature review. Int J Surg Case Rep 2015; 9:130-3. [PMID: 25768279 PMCID: PMC4392370 DOI: 10.1016/j.ijscr.2015.02.050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 02/24/2015] [Accepted: 02/25/2015] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Primary retroperitoneal mucinous cystic neoplasm is very rare and its histogenesis is unclear. PRESENTATION OF CASE This paper presents the case of a 31-year-old female in whom an incidentally detected retroperitoneal cystic mass, 6.5cm in size, was successfully resected through laparoscopic approach. Pathologic examination revealed a mucinous cystadenoma. The postoperative course was uneventful, and the patient remained free of recurrence six months after surgery. DISCUSSION Literature review showed that male sex (p=0.019), and solid nodules in cysts (p<0.001) were both significantly associated with malignancy. CONCLUSION When confronted with a cystic mass in the retroperitoneum, a primary mucinous cystic neoplasm should be considered and complete surgical removal of the tumor without spillage is recommended.
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Affiliation(s)
- Seung Eun Lee
- Department of Surgery, Chung-Ang University College of Medicine, Republic of Korea.
| | - Hyung Chul Oh
- Department of Internal Medicine, Division of Gastroenterology, Chung-Ang University College of Medicine, Republic of Korea
| | - Yong-Gum Park
- Department of Surgery, Chung-Ang University College of Medicine, Republic of Korea
| | - Yoo Shin Choi
- Department of Surgery, Chung-Ang University College of Medicine, Republic of Korea
| | - Mi Kyung Kim
- Department of Pahtology, Chung-Ang University College of Medicine, Republic of Korea
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Primary retroperitoneal mucinous cystadenoma with a sarcoma-like mural nodule: an immunohistochemical study with histogenetic considerations and literature review. Int J Gynecol Pathol 2013. [PMID: 23202791 DOI: 10.1097/pgp.0b013e31825f7c41] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Primary retroperitoneal mucinous cystadenomas (PRMCs) are extremely rare tumors and their association with sarcoma-like mural nodules (SLMNs) has not been described thoroughly. The aim of this study is to characterize the gross and microscopic features and the immunohistochemical profile of the first case of PRMC with SLMN and to discuss the differential diagnosis of SLMNs. The literature related to primary retroperitoneal mucinous tumors is reviewed in an attempt to clarify the histogenesis of the epithelial and sarcomatoid components of the associated mural nodules. A 34-yr-old woman presented with a 14-cm retroperitoneal cystic lesion with a 6-cm mural nodule. An immunohistochemical study with a panel of 19 antibodies and a histochemical study for mucin stains were performed. The epithelial component of the PRMC showed positive staining for cytokeratin (CK) 7, CK AE1/3, epithelial membrane antigen, carcinoembryonic antigen, and calretinin. The neoplasm was not immunoreactive for CK 20, CK 5/6, and the other antibodies used in this study. In addition, it stained positively for mucin by mucicarmine, periodic acid-Schiff, and Alcian blue. The stromal cells of the cyst showed estrogen receptor positivity. SLMN cells were negative for all CKs and other epithelial markers used in the study, but they showed diffuse positive staining for vimentin and CD68, and positive staining for Ki-67 was demonstrated in 25% of these cells. The immunohistochemical and histochemical profiles of PRMC were similar to those of ovarian mucinous neoplasms and the mesothelium. The formation of SLMNs seems to be related to subepithelial hemorrhage and some reactive epithelial changes near the mural nodules. The specific immunohistochemical and morphologic features of SLMNs are helpful in differentiating them from malignant mural nodules, including true sarcomas, osteoclast-rich undifferentiated carcinomas, and carcinosarcomas. Such a differentiation is critical in view of its significant impact on the management of these neoplasms, particularly in young patients who desire to preserve their fertility.
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Navin P, Meshkat B, McHugh S, Beegan C, Leen E, Prins H, Aly S. Primary retroperitoneal mucinous cystadenoma-A case study and review of the literature. Int J Surg Case Rep 2012; 3:486-8. [PMID: 22809878 DOI: 10.1016/j.ijscr.2012.05.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 05/11/2012] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Primary retroperitoneal tumours of mucinous type are extremely rare and can be further sub-divided into benign, borderline or cystadenocarcinoma. Prompt diagnosis of retroperitoneal tumours is important as the majority are malignant. PRESENTATION OF CASE Our case describes a 30year old woman, presenting with a 3month history of intermittent right iliac fossa pain. Abdominal examination demonstrated a mass palpable in the right iliac fossa. Ultrasonography of the abdomen demonstrated a cystic mass with a magnetic resonance imaging (MRI) scan of the pelvis further defining the lesion. Laparoscopy was performed to further evaluate and ultimately remove the retroperitoneal mass. Macroscopic and microscopic examination reported mucinous epithelium of endocervical type with no evidence of invasion. Findings were consistent with primary retroperitoneal mucinous cystadenoma. DISCUSSION This is the 19th reported case of a benign primary retroperitoneal mucinous cystadenoma in the English literature. The origin of mucinous cystadenomas in the retroperitoneum is widely debated with multiple theories suggested. Diagnosis of retroperitoneal tumours is important but difficult as serological investigations, ultrasonography, computed topography and magnetic resonance imaging, although useful, cannot allow a confident diagnosis. CONCLUSION Primary retroperitoneal mucinous cystadenoma is a benign tumour, however because of the malignant nature of the majority of mucinous retroperitoneal tumours they should be considered in the differential of chronic abdominal pain despite their rarity.
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Affiliation(s)
- P Navin
- Department of Surgery, Connolly Memorial Hospital, Blachardstown, Dublin 15, Ireland
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A Case of Retroperitoneal Mucinous Cystadenoma Treated Successfully by Laparoscopic Excision. Surg Laparosc Endosc Percutan Tech 2008; 18:516-9. [DOI: 10.1097/sle.0b013e318174464c] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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11
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Kashima K, Yahata T, Fujita K, Tanaka K. Primary retroperitoneal mucinous cystadenocarcinoma associated with pregnancy. Int J Gynecol Cancer 2008; 18:908-12. [DOI: 10.1111/j.1525-1438.2007.01130.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Primary retroperitoneal mucinous cystadenocarcinoma (PRMC) is an extremely rare tumor. Only 30 cases have been reported previously in the English literature, and little information is available concerning its treatment and prognosis. The patient was a 28-year-old woman, presenting with a right mid-abdominal tumor at 26 weeks of gestation. At 31 weeks of gestation, she underwent an exploratory laparotomy and was diagnosed with a PRMC. No disseminated tumor was observed, and an excision of only the tumor was performed. She had an uneventful vaginal delivery at 38 weeks of gestation and remains free of disease at 13 months after the operation. This report describes a case of PRMC associated with pregnancy. The optimal management of these retroperitoneal masses during pregnancy is discussed. Based on limited experience and the current literature, a PRMC with an intact capsule and no dissemination appears to have a good prognosis and can be treated by tumor excision alone in patients who wish to preserve fertility
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Youssef C, Mathelin C, Guerin C, Roy C, Walter P, Rodriguez B, Brettes JP. Primary retroperitoneal endometrial cystadenocarcinoma presenting as pelvic abscess on ultrasound. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 31:714-715. [PMID: 18504785 DOI: 10.1002/uog.5342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Lee SA, Bae SH, Ryoo HM, Jung HY, Jang SB, Kum YS. Primary retroperitoneal mucinous cystadenocarcinoma: a case report and review of the literature. Korean J Intern Med 2007; 22:287-91. [PMID: 18309690 PMCID: PMC2687666 DOI: 10.3904/kjim.2007.22.4.287] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Primary retroperitoneal mucinous cystadenocarcinoma is a rare tumor. Only about 30 such cases have been reported in the worldwide literature, and a few Korean cases have been reported. The pathogenesis is not clear, and coelomic metaplasia of the retroperitoneal mesothelium has gained wide support. There is no consensus on the appropriate treatment, but surgical exploration is needed for the diagnosis and treatment, and adjuvant chemotherapy may be recommended following complete surgical excision. The long-term prognosis has not been established. We report here on a 32-year-old woman who was diagnosed as having a retroperitoneal mucinous cystadenocarcinoma with mural nodules of sarcomatoid change. Tumor excision and adjuvant chemotherapy were done and the patient is doing well without any evidence of recurrence at 42 months postoperatively.
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Affiliation(s)
- Sun Ah Lee
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Sung Hwa Bae
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Hun Mo Ryoo
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Hyun Young Jung
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Saet Byul Jang
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Yoon Seup Kum
- Department of Pathology, Catholic University of Daegu School of Medicine, Daegu, Korea
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Hoang TT, Qiu S, Rodriguez G. Rare Cystic Mucinous Cystadenoma Presenting as a Scrotal Mass. Urology 2007; 70:1223.e3-5. [DOI: 10.1016/j.urology.2007.09.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Revised: 08/15/2007] [Accepted: 09/19/2007] [Indexed: 10/22/2022]
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Tjalma WAA, Vaneerdeweg W. Primary retroperitoneal mucinous cystadenocarcinomas are a distinct entity. Int J Gynecol Cancer 2007; 18:184-8. [PMID: 17506841 DOI: 10.1111/j.1525-1438.2007.00981.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Primary retroperitoneal mucinous cystadenocarcinomas are rare tumors with a controversial pathogenesis. Present report describes a 74-year-old woman with a retroperitoneal cystic pelvic mass. Her past medical history included appendectomy, bilateral salpingo-oophorectomy, and a hysterectomy. An explorative laparotomy was performed and the mass was completely excised. Definitive pathology revealed a primary retroperitoneal mucinous cystadenocarcinoma of the ovarian type. Further management consisted of four cycles carboplatin. She had a recurrence after 8 months and died 31 months after the initial diagnosis. Primary retroperitoneal mucinous cystadenocarcinomas are distinct entity, with the same poor prognosis as their ovarian counterpart.
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Affiliation(s)
- W A A Tjalma
- Department of Gynecological Oncology, University Hospital Antwerp, Antwerp, Belgium.
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Green JM, Bruner BC, Tang WW, Orihuela E. Retroperitoneal mucinous cystadenocarcinoma in a man: case report and review of the literature. Urol Oncol 2007; 25:53-5. [PMID: 17208139 DOI: 10.1016/j.urolonc.2006.02.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2005] [Revised: 02/17/2006] [Accepted: 02/20/2006] [Indexed: 11/28/2022]
Abstract
In the English medical literature, 27 cases of primary retroperitoneal mucinous cystadenocarcinoma have been published. We report the second case of a primary retroperitoneal mucinous cystadenocarcinoma in a man. The patient was an 83-year-old man, with a large 26 x 20 x 16-cm retroperitoneal cystic mass causing abdominal discomfort and cachexia, who underwent excision of the mass. Prior reports suggest that this type of tumor has an aggressive clinical course, and surgical excision is the treatment of choice. These rare tumors need to be included in the differential of retroperitoneal cystic tumors.
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Affiliation(s)
- Justin M Green
- Division of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
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17
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Thamboo TP, Sim R, Tan SY, Yap WM. Primary retroperitoneal mucinous cystadenocarcinoma in a male patient. J Clin Pathol 2006; 59:655-7. [PMID: 16731606 PMCID: PMC1860402 DOI: 10.1136/jcp.2005.030122] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2005] [Indexed: 12/29/2022]
Abstract
Primary retroperitoneal mucinous cystadenocarcinomas (PRMCs) are rare. This is the first reported case in the literature in English of PRMC in a man. The 64-year-old man presented with a large retroperitoneal cystic tumour measuring 24 x 20 x 16 cm3, which was removed intact. Areas ranging from a benign mucinous cyst to borderline mucinous tumour to mucinous cystadenocarcinoma were observed on microscopy. Strong patchy staining for cytokeratins 7 and 20 and strong diffuse staining for MUC2 and MUC5AC core peptides, similar to staining patterns in ovarian mucinous tumours, were shown in the benign and atypical epithelium. Staining for CA19.9 and carcinoembryonic antigen was also shown by both components. The theory of its origin from the mucinous metaplasia of peritoneal (mesothelial) inclusion cysts, rather than from ectopic ovarian tissue or ovarian teratomas, is supported by the occurrence of such a tumour in a male patient.
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Affiliation(s)
- T P Thamboo
- Department of Pathology, National University of Singapore, Singapore, Republic of Singapore.
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18
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Law KS, Chang TM, Tung JN. Fertility-sparing treatment of a primary retroperitoneal mucinous cystadenocarcinoma. BJOG 2006; 113:612-4. [PMID: 16579797 DOI: 10.1111/j.1471-0528.2006.00917.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K S Law
- Department of Obstetrics and Gynaecology, Tungs' Taichung MetroHarbour Hospital & Taipei Medical University, WuCi, Taichung County, Taiwan.
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Matsubara M, Shiozawa T, Tachibana R, Hondo T, Osasda K, Kawaguchi K, Kimura K, Konishi I. Primary Retroperitoneal Mucinous Cystadenoma of Borderline Malignancy: A Case Report and Review of the Literature. Int J Gynecol Pathol 2005; 24:218-23. [PMID: 15968195 DOI: 10.1097/01.pgp.0000161313.30054.1d] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A case of primary retroperitoneal mucinous cystic tumor of borderline malignancy is reported. A 36-year-old, nulliparous woman complained of abdominal fullness. Physical examination revealed a cystic mass 12-cm x 8-cm in size. At laparotomy, a cystic tumor was observed in the right retroperitoneal space. Both ovaries appeared normal and the uterus was almost normal except for small myomatous nodules. Removal of the retroperitoneal tumor, an appendectomy, and a myomectomy were performed. The histologic diagnosis was a primary retroperitoneal mucinous cystic tumor of borderline malignancy, similar to findings for ovarian tumor. There was no evidence of disease 6 months after the surgery.
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Affiliation(s)
- Masakazu Matsubara
- Department of Obstetrics and Gynecology, Shinonoi General Hospital, Nagano, Japan
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Isse K, Harada K, Suzuki Y, Ishiguro K, Sasaki M, Kajiura S, Nakanuma Y. Retroperitoneal mucinous cystadenoma: Report of two cases and review of the literature. Pathol Int 2004; 54:132-8. [PMID: 14720145 DOI: 10.1111/j.1440-1827.2004.01595.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Primary retroperitoneal cystic tumor is extremely rare, and its histogenesis and biological behavior remain speculative. Two surgical cases of retroperitoneal mucinous cystadenoma (Case 1, an 18-year-old woman; and Case 2, an 85-year-old woman) are reported. The cystadenomas in these cases were mainly lined by a monolayer of columnar or thin flat cells. Case 1 was positive for mucin and epithelial membrane antigen, whereas Case 2 was positive for a mesothelial marker (calretinin). Ciliated epithelium was also interspersed in Case 2. Some parts showed papillary projections, resembling well-differentiated papillary mesothelioma. Within the cyst walls of both cases, ovarian-like stroma that was positive for both estrogen and progesterone receptors was found. Interestingly, focal nodular hyperplasia of the liver was also detected in Case 1. We believe the retroperitoneal mucinous cystadenoma might have arisen from the peritoneum via mucinous epithelial metaplasia with a phenotype of extragenital Mullerian system.
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Affiliation(s)
- Kumiko Isse
- Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
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21
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Kaku M, Ohara N, Seima Y, Imanishi K, Tomura N, Kobayashi A, Yamasaki M, Hirata Y, Murao S. A primary retroperitoneal serous cystadenocarcinoma with clinically aggressive behavior. Arch Gynecol Obstet 2003; 270:302-6. [PMID: 14551796 DOI: 10.1007/s00404-003-0550-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2003] [Accepted: 07/21/2003] [Indexed: 10/26/2022]
Abstract
CASE REPORT We describe a 44-year-old woman with a primary retroperitoneal serous cystadenocarcinoma as the fourth report in the world literature. A contrast-enhanced computed tomographic scan of the abdomen demonstrated a mass with enhanced solid mural nodules and septa in the left retroperitoneum. Serum CA19-9 was elevated at 181 U/ml. The patient underwent a complete resection of the retroperitoneal tumor with a partial resection of the psoas major muscle and its fascia. Pathological examination showed a well-differentiated papillary serous cystadenocarcinoma of ovarian type and locoregional lymph node metastases. Seven months after surgery, the patient developed a pelvic recurrence, and underwent a total hysterectomy, a left salpingo-oophorectomy and a resection of the metastatic mesenteric mass. Two months after the second surgery, serum CA19-9 and CA125 increased to 1,114 U/ml and 218 U/ml, respectively. A solitary liver metastasis was confirmed on a computed tomographic scan. The patient is now being treated with weekly docetaxel and carboplatin. CONCLUSION The present case illustrates the clinically aggressive nature of a primary retroperitoneal serous cystadenocarcinoma.
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Affiliation(s)
- M Kaku
- Department of Internal Medicine, Kaku Clinic, Kobe, Japan
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22
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Mikami M, Tei C, Takehara K, Komiyama S, Suzuki A, Hirose T. Retroperitoneal primary mucinous adenocarcinoma with a mural nodule of anaplastic tumor: a case report and literature review. Int J Gynecol Pathol 2003; 22:205-8. [PMID: 12649680 DOI: 10.1097/00004347-200304000-00017] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 38-year-old female presented with a lower abdominal mass. During the operation the mass was found to be retroperitoneal and was excised. Gross examination revealed a mucin-containing cystic lesion with a mural nodule. On microscopic examination, the cystic areas were lined by an invasive mucinous adenocarcinoma and the nodule was composed of an anaplastic sarcomatoid tumor that was immunoreactive for cytokeratin. This present case is the 21st example of a retroperitoneal primary mucinous cystadenocarcinoma and the fourth with a mural nodule. Three of four cases with a mural nodule, including our case, had a rapidly fatal outcome.
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Affiliation(s)
- Mikio Mikami
- Department of Obstetrics and Gynecology, National Saitama Hospital, Wako, Saitama, Japan
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23
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Kessler TM, Kessler W, Neuweiler J, Nachbur BH. Treatment of a case of primary retroperitoneal mucinous cystadenocarcinoma: is adjuvant hysterectomy and bilateral salpingo-oophorectomy justified? Am J Obstet Gynecol 2002; 187:227-32. [PMID: 12114915 DOI: 10.1067/mob.2002.119809] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We present a case of primary retroperitoneal mucinous cystadenocarcinoma in a 38-year-old woman. STUDY DESIGN The tumor was resected with a segment of adjacent descending colon. Five years after the operation, the patient is well, without evidence of recurring disease, based on clinical investigation and modern imaging techniques. RESULTS In the light of the literature, it appears most likely that this rare tumor is caused by coelomic metaplasia. On the basis of the histopathologic findings in our case and the reports from the literature, we recommend radical tumor excision en bloc with all infiltrated adjacent structures. CONCLUSION Added removal of unaffected uterus and adnexes makes young women infertile and climacteric and is not yet validated by long-term results.
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Affiliation(s)
- Thomas M Kessler
- Department of Surgery, Kantonales Spital Altstätten, St Gallen, Switzerland
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24
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Tangjitgamol S, Manusirivithaya S, Sheanakul C, Leelahakorn S, Thawaramara T, Kaewpila N. Retroperitoneal mucinous cystadenocarcinoma: a case report and review of literature. Int J Gynecol Cancer 2002; 12:403-8. [PMID: 12144691 DOI: 10.1046/j.1525-1438.2002.01120.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This is a case report of retroperitoneal mucinous cystadenocarcinoma which was operated on for a preoperative diagnosis of ovarian tumor. The tumor had no connection to other intra-abdominal organs including bilateral normal ovaries. Grossly, it was a well encapsulated, unilocular cyst containing mucous material. Histology revealed a typical area of benign, low malignant potential and malignant mucinous epithelium. No particular microscopic features suggested the origin of the tumor. We additionally performed total hysterectomy, bilateral salpingooophorectomy, and appendectomy after tumor resection and found no tumor elsewhere from these specimens. Prophylactic chemotherapy was also given. The patient was doing well 18 months postoperation. Due to its rarity, the prognosis and optimal treatment cannot be concluded with confidence at this time until more cases are reported.
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Affiliation(s)
- S Tangjitgamol
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Samsen Road, Dusit district, Bangkok, Thailand 10300
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25
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Abstract
Primary retroperitoneal mucinous cystadenoma is an uncommon tumor found exclusively in women. Herein, we describe a patient who had resection of a large retroperitoneal cystic mass. Histologic, immunohistochemical, and electron microscopic examination of the lining epithelial cells showed features of mesothelial cells in addition to ovarian mucinous cystadenoma. These findings suggest that these tumors arise from inclusions of mesothelial cells and subsequent mucinous metaplasia of the lining cells to form a cystadenoma. Estrogen receptors may be implicated in tumor promotion, explaining the occurrence exclusively in women.
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Affiliation(s)
- C Subramony
- Department of Pathology, 2500 N State St, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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26
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Affiliation(s)
- P A Linden
- Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, MA 02115, USA
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27
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Uematsu T, Kitamura H, Iwase M, Tomono H, Nakamura M, Yamashita K, Ogura H. Ruptured retroperitoneal mucinous cystadenocarcinoma with synchronous gastric carcinoma and a long postoperative survival: case report. J Surg Oncol 2000; 73:26-30. [PMID: 10649275 DOI: 10.1002/(sici)1096-9098(200001)73:1<26::aid-jso7>3.0.co;2-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We describe an 86-year-old woman with a long survival following surgey for a massive retroperitoneal mucinous cystadenocarcinoma and a synchronous gastric carcinoma. Computed tomography showed a huge tumor with septation and calcification. Upper gastrointestinal radiography showed the additional gastric lesion. At operation, the 23 x 20 x 12-cm retroperitoneal tumor had ruptured. Tumor resection and distal gastrectomy including regional lymph nodes were performed. Mucinous peritoneal implants were removed as completely as possible. Histologically, the mucinous tumor showed limited invasion, whereas the poorly differentiated gastric adenocarcinoma showed no serosal invasion. Among 18 retroperitoneal mucinous cystadenocarcinomas reported in the English literature since 1965, only ours was associated with gastric carcinoma. Despite peritoneal implants, our patient has survived for 6 years without clinical recurrence. As at other sites, retroperitoneal mucinous cystadenocarcinoma often grows slowly. Total removal, even after peritoneal dissemination, can result in long survival.
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Affiliation(s)
- T Uematsu
- Department of Surgery, Iwata Municipal General Hospital, Japan
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28
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Dore R, La Fianza A, Storti L, Babilonti L, Preda L, Di Maggio EM, Tenti P. Primitive mucinous cystadenocarcinoma of the retroperitoneum. Case report and diagnostic considerations. Clin Imaging 1996; 20:129-32. [PMID: 8744823 DOI: 10.1016/0899-7071(95)00004-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The combination of ultrasonography (US) and computed tomography (CT) proved useful in recognizing and defining the characteristics of a primitive mucinous cystadenocarcinoma of the retroperitoneum, a rare anatomopathological finding which consistently presents certain macroscopic features that help in the formulation of a diagnosis with imaging techniques.
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Affiliation(s)
- R Dore
- Istituto di Radiologia, IRCCS Policlinico S. Matteo, Pavia, Italy
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29
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Tenti P, Romagnoli S, Pellegata NS, Zappatore R, Giunta P, Ranzani GN, Carnevali L. Primary retroperitoneal mucinous cystoadenocarcinomas: an immunohistochemical and molecular study. Virchows Arch 1994; 424:53-7. [PMID: 7981904 DOI: 10.1007/bf00197393] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Special immunohistochemical stains for the identification of gastroenteropancreatic antigens in two cases of primary retroperitoneal mucinous cystoadenocarcinomas (PRMC) show that these tumours have patterns similar to ovarian mucinous tumours. Markers of pyloric type gastric mucosa differentiation (M1, cathepsin E, concavavalin A, pepsinogen II) are mostly positive in benign and borderline areas with endocervical type differentiation, while immunoreactivity for intestinal cell markers (M3SI and CAR-5) and for DU-PAN-2 is present mainly in frankly malignant areas, regardless of differentiation type. DNA analysis shows a point mutation of K-ras oncogene at codon 12 (GGT to CGT) in one case. The immunohistochemical and genotypic similarity of PRMC and ovarian mucinous tumours may indicate similar mechanisms in their histogenesis.
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Affiliation(s)
- P Tenti
- Department of Pathology, University of Pavia, Italy
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30
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Rothacker D, Knolle J, Stiller D, Borchard F. Primary retroperitoneal mucinous cystadenomas with gastric epithelial differentiation. Pathol Res Pract 1993; 189:1195-204. [PMID: 8183741 DOI: 10.1016/s0344-0338(11)80844-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We present two rare cases of retroperitoneal mucinous cystadenomas (RMC) by clinical data, light microscopy, electron microscopy, histochemistry, and immunohistochemistry. Both tumors occurred in women. We excluded attachment to any organ. Additional immunohistochemical examinations were performed for comparison in 10 cases of ovarian mucinous cystadenomas (OMC). Both RMC showed no significant immunohistochemical differences from the OMC. Ultrastructurally and histologically the RMC resemble OMC reported in the literature. Immunohistologically, we proved gastric epithelial differentiation by using one monoclonal antibody (2B5) recognizing gastric mucin and one polyclonal antibody against pepsinogen II (PG II). In spite of this, the histogenesis of RMC in the presented cases in the end remains uncertain.
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Affiliation(s)
- D Rothacker
- Center of Pathology, Heinrich-Heine-University Düsseldorf, Germany
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