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Mucinous cystic neoplasms of the pancreas with ovarian stroma
Author(s) -
Gil Eunmi,
Choi Seong Ho,
Choi Dong Wook,
Heo Jin Seok,
Kim Min Jung
Publication year - 2013
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2012.06295.x
Subject(s) - medicine , malignancy , dysplasia , pancreas , asymptomatic , lymph node , cyst , stroma , pathology , radiology , immunohistochemistry
Backgrounds Mucinous cystic neoplasms ( MCN s) of the pancreas are rare, but have recently been increasing in incidence. The aim of this retrospective clinical study was to elucidate the clinicopathological features and prognosis of MCN s with ovarian stroma at a single centre. Methods Using the presence of ovarian stroma as a requisite criterion for diagnosis of MCN s, the medical records of 47 surgically treated patients with MCN s from J anuary 2004 to A pril 2011 were reviewed and classified according to the new 2010 W orld H ealth O rganization classification. Results Included were 37 cases of low‐grade (78.7%), 4 intermediate‐grade (8.5%) and 1 high‐grade dysplasia (8.5%), and 5 cases of invasive carcinomas (10.6%). Patients were exclusively women (91.5%) with a mean age of 48.5 years. Most tumours were in the pancreatic body/tail (89.4%) with a mean size of 5.24 cm. More than half were asymptomatic. Findings associated with malignancy were presence of mural nodules ( P < 0.001) and cyst wall calcifications ( P = 0.017). All invasive MCN s were ≥5.0 cm or had mural nodules. No lymph node metastasis was seen in 20 cases of lymph nodes dissected. None of the 42 patients with non‐invasive MCN s recurred after a mean follow‐up of 25 months. However, two of five patients with invasive MCN s recurred, and one died within 2 years. Conclusions The prognosis of the resected non‐invasive MCN s was excellent. Although resection should be considered for all cases, in low‐risk MCN s (<5 cm and without nodules), nonradical resections (i.e. enucleations) are appropriate.