Pancreatic mucinous cystic neoplasm defined by ovarian stroma: Demographics, clinical features, and prevalence of cancer

Raghuram P. Reddy, Thomas Christopher Smyrk, Mauricio Zapiach, Michael J. Levy, Randall K. Pearson, Jonathan E. Clain, Michael B. Farnell, Michael G. Sarr, Suresh T Chari

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Abstract

Background & Aims: Pancreatic mucin-producing cystic neoplasms are classified into 2 distinct entities: mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). In previous studies, MCN often has been defined loosely and has not always been distinguished clearly from IPMN. Our aims were to determine the demographics, clinical features, and prevalence of invasive cancer in MCN defined by the presence of characteristic ovarian stroma. Methods: By using the presence of ovarian stroma as a requisite criterion for diagnosis of MCN, a single pathologist, unaware of clinical information, identified 56 MCNs from 243 mucin-producing neoplasms resected at Mayo Clinic between 1986 and 2003. Medical records of the MCN patients were reviewed to obtain clinical and demographic data. Results: Patients with MCN were almost exclusively (98%) women; we identified 1 man with a neoplasm containing ovarian stroma. The mean (±SD) age at resection was 48 ± 15 years (84% < 60 y). Abdominal pain was the most common presenting symptom; 16% were asymptomatic. Most MCN (93%) were in the pancreatic body/tail region. Their median size was 5 cm (61% <5 cm). Histologically, 50 (89%) were adenomas, 2 (4%) had carcinoma-in-situ, and 4 (7%) had invasive cancer. None of the 22 MCNs <5 cm in size had invasive cancer. No patient with noninvasive disease had a recurrence after resection. Conclusions MCN defined by ovarian stroma has a distinct demographic and clinical profile and a low prevalence of invasive cancer. These observations suggest that ovarian stroma should be used as the defining criterion for diagnosing MCN.

Original languageEnglish (US)
Pages (from-to)1026-1031
Number of pages6
JournalClinical Gastroenterology and Hepatology
Volume2
Issue number11
DOIs
StatePublished - Nov 2004

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Ovarian Neoplasms
Demography
Neoplasms
Mucins
Body Regions
Carcinoma in Situ
Adenoma
Abdominal Pain
Medical Records

ASJC Scopus subject areas

  • Gastroenterology

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Pancreatic mucinous cystic neoplasm defined by ovarian stroma : Demographics, clinical features, and prevalence of cancer. / Reddy, Raghuram P.; Smyrk, Thomas Christopher; Zapiach, Mauricio; Levy, Michael J.; Pearson, Randall K.; Clain, Jonathan E.; Farnell, Michael B.; Sarr, Michael G.; Chari, Suresh T.

In: Clinical Gastroenterology and Hepatology, Vol. 2, No. 11, 11.2004, p. 1026-1031.

Research output: Contribution to journalArticle

Reddy, Raghuram P. ; Smyrk, Thomas Christopher ; Zapiach, Mauricio ; Levy, Michael J. ; Pearson, Randall K. ; Clain, Jonathan E. ; Farnell, Michael B. ; Sarr, Michael G. ; Chari, Suresh T. / Pancreatic mucinous cystic neoplasm defined by ovarian stroma : Demographics, clinical features, and prevalence of cancer. In: Clinical Gastroenterology and Hepatology. 2004 ; Vol. 2, No. 11. pp. 1026-1031.
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abstract = "Background & Aims: Pancreatic mucin-producing cystic neoplasms are classified into 2 distinct entities: mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). In previous studies, MCN often has been defined loosely and has not always been distinguished clearly from IPMN. Our aims were to determine the demographics, clinical features, and prevalence of invasive cancer in MCN defined by the presence of characteristic ovarian stroma. Methods: By using the presence of ovarian stroma as a requisite criterion for diagnosis of MCN, a single pathologist, unaware of clinical information, identified 56 MCNs from 243 mucin-producing neoplasms resected at Mayo Clinic between 1986 and 2003. Medical records of the MCN patients were reviewed to obtain clinical and demographic data. Results: Patients with MCN were almost exclusively (98{\%}) women; we identified 1 man with a neoplasm containing ovarian stroma. The mean (±SD) age at resection was 48 ± 15 years (84{\%} < 60 y). Abdominal pain was the most common presenting symptom; 16{\%} were asymptomatic. Most MCN (93{\%}) were in the pancreatic body/tail region. Their median size was 5 cm (61{\%} <5 cm). Histologically, 50 (89{\%}) were adenomas, 2 (4{\%}) had carcinoma-in-situ, and 4 (7{\%}) had invasive cancer. None of the 22 MCNs <5 cm in size had invasive cancer. No patient with noninvasive disease had a recurrence after resection. Conclusions MCN defined by ovarian stroma has a distinct demographic and clinical profile and a low prevalence of invasive cancer. These observations suggest that ovarian stroma should be used as the defining criterion for diagnosing MCN.",
author = "Reddy, {Raghuram P.} and Smyrk, {Thomas Christopher} and Mauricio Zapiach and Levy, {Michael J.} and Pearson, {Randall K.} and Clain, {Jonathan E.} and Farnell, {Michael B.} and Sarr, {Michael G.} and Chari, {Suresh T}",
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T1 - Pancreatic mucinous cystic neoplasm defined by ovarian stroma

T2 - Demographics, clinical features, and prevalence of cancer

AU - Reddy, Raghuram P.

AU - Smyrk, Thomas Christopher

AU - Zapiach, Mauricio

AU - Levy, Michael J.

AU - Pearson, Randall K.

AU - Clain, Jonathan E.

AU - Farnell, Michael B.

AU - Sarr, Michael G.

AU - Chari, Suresh T

PY - 2004/11

Y1 - 2004/11

N2 - Background & Aims: Pancreatic mucin-producing cystic neoplasms are classified into 2 distinct entities: mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). In previous studies, MCN often has been defined loosely and has not always been distinguished clearly from IPMN. Our aims were to determine the demographics, clinical features, and prevalence of invasive cancer in MCN defined by the presence of characteristic ovarian stroma. Methods: By using the presence of ovarian stroma as a requisite criterion for diagnosis of MCN, a single pathologist, unaware of clinical information, identified 56 MCNs from 243 mucin-producing neoplasms resected at Mayo Clinic between 1986 and 2003. Medical records of the MCN patients were reviewed to obtain clinical and demographic data. Results: Patients with MCN were almost exclusively (98%) women; we identified 1 man with a neoplasm containing ovarian stroma. The mean (±SD) age at resection was 48 ± 15 years (84% < 60 y). Abdominal pain was the most common presenting symptom; 16% were asymptomatic. Most MCN (93%) were in the pancreatic body/tail region. Their median size was 5 cm (61% <5 cm). Histologically, 50 (89%) were adenomas, 2 (4%) had carcinoma-in-situ, and 4 (7%) had invasive cancer. None of the 22 MCNs <5 cm in size had invasive cancer. No patient with noninvasive disease had a recurrence after resection. Conclusions MCN defined by ovarian stroma has a distinct demographic and clinical profile and a low prevalence of invasive cancer. These observations suggest that ovarian stroma should be used as the defining criterion for diagnosing MCN.

AB - Background & Aims: Pancreatic mucin-producing cystic neoplasms are classified into 2 distinct entities: mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). In previous studies, MCN often has been defined loosely and has not always been distinguished clearly from IPMN. Our aims were to determine the demographics, clinical features, and prevalence of invasive cancer in MCN defined by the presence of characteristic ovarian stroma. Methods: By using the presence of ovarian stroma as a requisite criterion for diagnosis of MCN, a single pathologist, unaware of clinical information, identified 56 MCNs from 243 mucin-producing neoplasms resected at Mayo Clinic between 1986 and 2003. Medical records of the MCN patients were reviewed to obtain clinical and demographic data. Results: Patients with MCN were almost exclusively (98%) women; we identified 1 man with a neoplasm containing ovarian stroma. The mean (±SD) age at resection was 48 ± 15 years (84% < 60 y). Abdominal pain was the most common presenting symptom; 16% were asymptomatic. Most MCN (93%) were in the pancreatic body/tail region. Their median size was 5 cm (61% <5 cm). Histologically, 50 (89%) were adenomas, 2 (4%) had carcinoma-in-situ, and 4 (7%) had invasive cancer. None of the 22 MCNs <5 cm in size had invasive cancer. No patient with noninvasive disease had a recurrence after resection. Conclusions MCN defined by ovarian stroma has a distinct demographic and clinical profile and a low prevalence of invasive cancer. These observations suggest that ovarian stroma should be used as the defining criterion for diagnosing MCN.

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