Carcinoma mucinoso de mama: una estirpe histológica rara de pronóstico favorable / Mucinous Carcinoma of the Breast: A Rare Histological Type with a Favorable Prognosis

Resumen El carcinoma mucinoso es una estirpe poco frecuente de cáncer de mama, la cual representa menos del 4% de todos los cánceres primarios. Suele presentarse en pacientes postmenopáusicas, alrededor de la séptima década de la vida. Clínicamente se caracteriza por manifestarse como un nódulo palpable, rara vez acompañado de otra sintomatología. Las herramientas de imagen, como la mastografía y el ultrasonido, son fundamentales para su diagnóstico; sin embargo, en algunas situaciones se puede subestimar el diagnóstico dado a las características similares que comparte con otras lesiones benignas. El diagnóstico definitivo se realiza por medio de histopatología. Debido a la rareza de estos tumores, no existe un consenso sobre el tratamiento más adecuado. Muchos autores concuerdan que la intervención quirúrgica continúa siendo la piedra angular, ya que tiene un impacto positivo en la supervivencia y baja incidencia de recurrencias. Esta se puede acompañar posteriormente de terapias endocrinas adyuvantes. Afortunadamente, el pronóstico de este tipo de tumores suele ser favorable, incluso la supervivencia supera el 90% a los 5 años.

Abstract Mucinous carcinoma is a rare type of breast cancer, which represents less than 4% of all primary cancers. It usually occurs in postmenopausal patients, around the seventh decade of life. Clinically, it is characterized by the presence of a palpable nodule, rarely accompanied by other symptoms. Imaging tools, such as mammogram and ultrasound, are essential for its diagnosis, however, in some situations the diagnosis can be underestimated due to the similar characteristics that it shares with other benign lesions. Definitive diagnosis is made by histopathology. Regarding treatment, there is no consensus on the most appropriate, due to the low incidence of these tumors. Many authors agree that surgical intervention continues to be the best option, showing a positive impact on survival and low recurrences. This can be accompanied later by adjuvant endocrine therapies. Fortunately, the prognosis of this type of tumor is usually favorable, even survival exceeds 90% at 5 years.

A rare case of giant mucinous cystadenocarcinoma of the right ovary with metastatic deposits and Brenner tumor in the left ovary

Ovarian cancer is the second most common gynecological malignancy. Mucinous tumor accounts for 3% of ovarian tumors and is a challenging task for a surgical pathologist. Association of Brenner tumor, a subtype of epithelial malignancy is a rare entity reported in the literature. Herein, we report a unique case of a 57-years old post-menopausal woman who presented with progressive abdominal distention for 3 years and constipation for 1 year. Clinically, it was suspected as a case of complex ovarian cyst and the patient underwent staging laparotomy. Intraoperatively, a giant mucinous cystadenocarcinoma of the right ovary with deposits in the pouch of Douglas, omentum, umbilical, and the sub-umbilical region was found along with a benign Brenner tumor of the left ovary.

Role of magnetic resonance imaging in the differentiation of mucinous ovarian carcinoma and mucinous borderline ovarian tumors

SUMMARY OBJECTIVE: This study was carried out to investigate the differentiation of mucinous borderline ovarian tumor from mucinous ovarian carcinoma using magnetic resonance imaging. METHODS: We evaluated 77 women patients who underwent abdominal magnetic resonance imaging due to pelvic mass. magnetic resonance imaging was reviewed by an experienced radiologist. A total of 70 women patients were included in the study. The magnetic resonance imaging features were retrospectively evaluated and compared between the two pathologies. RESULTS: There was no difference between the two groups in terms of maximum tumor size. Age at diagnosis was 56.29±11.92 in the mucinous ovarian carcinoma group and 44.74±13.60 in the mucinous borderline ovarian tumor group (p<0.05). A significant difference was found between the two groups, and it was observed that mucinous borderline ovarian tumors appeared in the younger age group compared to mucinous ovarian carcinomas. Presence of ascites, peritoneal dissemination, lymphadenopathy, and mural nodules was found significantly more frequently in mucinous ovarian carcinomas than in mucinous borderline ovarian tumors. Honeycomb appearance was found more frequently in mucinous borderline ovarian tumor patients than in mucinous ovarian carcinoma patients. CONCLUSION: magnetic resonance imaging findings of these two pathologies overlapped considerably. Compared with mucinous borderline ovarian tumors, mucinous ovarian carcinomas frequently had mural nodules larger than 5 mm, larger tumor size, peritoneal dissemination, and abnormal ascites.

Primary mucinous carcinoma of skin with a trichoadenomatous component: A rare case report

Primary mucinous carcinoma of the skin is a rare subtype of eccrine sweat gland tumors. Differentiating it from metastatic adenocarcinomas is important in the management of this condition. We report the case of a 55-year-old female presenting with a painless nodule, which was subsequently diagnosed as primary mucinous carcinoma of skin with a trichoadenomatous component. The possibility of a metastatic adenocarcinoma was ruled out by performing ultrasound abdomen, total body computed tomography, mammogram and colonoscopy.

Mucinous carcinoma is a predictive factor for the risk of open conversion from laparoscopic colectomy in colorectal cancer

PURPOSE: Although laparoscopic surgery is widely accepted in the treatment of colorectal cancer, conversion to open surgery is associated with the rate of unfavorable outcomes. The aim of this study was to determine the factors associated with open conversion from laparoscopic surgery for colorectal cancer.METHODS: A total of 3,002 patients who underwent laparoscopic colectomy as an initial plan for the treatment of colorectal cancer located from the sigmoid colon to the rectum were retrospectively evaluated between January 2009 and December 2018 at Samsung Medical Center in Korea. Risk factors significantly associated with open conversion were determined using univariate and multivariate regression models.RESULTS: Among the 3,002 patients, open conversion was performed in 120 patients (4%). Age >60 years (adjusted odds ratio [AOR], 2.370), preoperative bowel obstruction (AOR, 2.348), clinical T4 stage (AOR, 2.201), and serum carcinoembryonic antigen level >5 ng/mL (AOR, 2.289) were significantly associated with open conversion. Moreover, mucinous carcinoma was a significantly more frequent histopathologic type than adenocarcinoma (10.0% vs. 3.2%, P<0.001) in the open conversion group with an AOR of 2.549 (confidence interval, 1.259–5.159; P=0.009).CONCLUSION: The present study presented a novel finding, i.e. mucinous carcinoma as the histopathologic type could be an independent predictive factor for conversion from laparoscopic colectomy to open surgery. Identifying patients with mucinous carcinoma will help stratify the risk of open conversion preoperatively.

Primary Cutaneous Mucinous Carcinoma with Extramammary Paget’s Disease: Eccrine or Apocrine?

Primary cutaneous mucinous carcinoma (PCMC) is an uncommon tumor of the sweat gland origin. The occurrence of PCMC is mostly in middle-aged and older patients, with a slight male predominance. Most cases of PCMC arise on the head, with a preference for eyelids. The histogenesis of PCMC, whether eccrine or apocrine, remains controversial. We report a rare case of PCMC with secondary extramammary Paget’s disease in the groin of a 75-year-old man, which favored an apocrine origin. Furthermore, based on a review of the literature, we provide several histologic clues that can be used to differentiate PCMC from metastatic mucinous carcinoma.

Multimodel functional MRI in the differential diagnosis of breast mucinous carcinoma and phyllodes tu-mor(≥3 cm) / 实用医学杂志

Objective To investigate the application value of functional MRI in the differential diagnosis between breast mucinous carcinoma and phyllodes tumor(≥ 3 cm). Methods 55 cases of breast mucinous adeno-carcinoma and phyllodes tumors(≥ 3 cm)from January 2012 to December 2017 were retrospectively analyzed. MRI features of 20 mucinous carcinomas and 35 phyllodes tumors were analyzed,compared with pathology. Re-sults There were 20 cases of breast mucinous carcinoma in current study,including 14 cases of pure mucinous carcinoma and 6 cases of mixed mucinous carcinoma. There were 35 cases of phyllodes tumors,including 9 be-nign,18 borderline and 8 malignant cases. There was no significant difference in T1WI signal and enhancement mode between breast mucinous carcinoma and phyllodes tumors. There were significant differences in age,long di-ameter,morphology,lobulation,border,ADC value,EER,T2WI signal and TIC curve pattern(P < 0.05). The area under ROC(AUC)of ADC value and EER for breast mucinous adenocarcinoma and phyllodes tumor was 0.7036 and 0.8029,respectively. Conclusions Multi-model functional MRI can effectively distinguish breast mucinous adenocarcinoma from phyllodes tumor(≥ 3 cm),and EER is more accurate than ADC value.

MRI features of mucinous carcinoma and myxoidfibroadenoma of the breast / 中华放射学杂志

Objective To study the features of mucinous carcinoma and myxoidfibroadenoma of the breast on MRI.Methods Fourty patients with pure mucinous carcinoma and myxoidfibroadenoma confirmed by surgical pathology who underwent breast MRI from January 2010 to May 2017 in Tianjin Medical University Cancer Institute and Hospital were analyzed retrospectively, including 26 patients with mucinous carcinoma and 14 patients with myxoidfibroadenoma. By use of the Breast Imaging Reporting and Data System (BI-RADS) lexicon, an analysis of the shape, margin, infiltration to adjacent tissues, the lesion location, signal intensity in the T1WI and fat-suppressed T2WI, dark internal septation, the pattern of time-signal intensity curve (TIC),rim enhancement, delayed internal enhancement, the DWI signal and ADC values was performed. Qualitative data and quantitative data were compared with χ2test and independent sample t test respectively. Results There were significant differences in the margin,dark internal septation,the lesion location, rim enhancement and delayed internal enhancement between mucinous carcinoma and myxoidfibroadenoma(P＜0.05). The shape, signal intensity in the T1WI and fat-suppressed T2WI,infiltration to adjacent tissues, the pattern of TIC, the DWI signal and ADC values were not statistically significant between the two groups(P＞0.05).Conclusion The combination of irregular margin, less frequent dark internal septation, rim enhancement in the early phase, delayed heterogeneous enhancement and the lesion location where was in the shallow layer of fibro-glandular tissue were significant findings for differentiation between mucinous carcinoma and myxoidfibroadenoma.

Hallazgos clínico-patológicos del cáncer mucinoso de la mama / Pathological and clinical findings of mucinous carcinoma of the breast

Resumen OBJETIVO: Determinar la frecuencia y los hallazgos clínico-patológicos del carcinoma mucinoso de la mama. MATERIALES Y MÉTODOS: Estudio retrospectivo, observacional, descriptivo y transversal consistente en el análisis de los expedientes clínicos de pacientes atendidas en el Hospital de Ginecología Luis Castelazo Ayala entre el 1 de enero de 2009 y el 31 de diciembre 2016 con muestras quirúrgicas referidas por el servicio de Anatomía patológica con diagnóstico de carcinoma mucinoso de la mama. Criterios de inclusión: casos de carcinoma mucinoso de la mama. Criterios de exclusión: ausencia de registro de biopsia o de reporte histológico, carcinoma de la mama asociado con otro tipo histológico distinto. RESULTADOS: Se encontraron 64 casos de carcinoma mucinoso invasor de la mama. Promedio de edad: 61.9 años (límites 32 y 95). Diez pacientes se ubicaron en el grupo de 66 a 70 años y 8 en el de 41 a 45 años. Se registraron 49 casos de carcinoma mucinoso puro y 15 de carcinoma mixto, de éstos 9 correspondieron al tipo histológico ductal, 1 al tipo lobulillar, 3 al ductolobulillar y 2 de otra variante histológica. CONCLUSIONES: El carcinoma mucinoso es una variante rara del carcinoma invasivo del conducto mamario que aparece en mujeres de edad avanzada. El diagnóstico y el tratamiento oportuno son posibles mediante mamografía y confirmación histopatológica.

Abstract OBJECTIVE: To determine the frequency and clinicopathological findings of Mucinous carcinoma of the breast. MATERIALS AND METHODS: Retrospective, observational, descriptive and transversal study. Analyzed the clinical records of patients whose surgical samples were referred to the pathology Department of the Hospital of Gynecology Luis Castelazo Ayala with the diagnosis of Mucinous carcinoma of the breast, during the 01 of January 2009 to the December 31, 2016. Inclusion criteria all cases of Mucinous carcinoma of the breast and the exclusion of those who did not have record of biopsy or absence of histological report, carcinoma of the breast associated with another different histological type. RESULTS: 64 cases with invasive Mucinous carcinoma of the breast between 2009 and 2016 were reported. The average age was 61.9 years (32 to 95 limits). We identified 10/64 patients aged 66 to 70 years and 8/64 in the 41 to 45 years. There were 49/64 Mucinous carcinoma of pure and 15/64 mixed carcinoma, of which 9/15 corresponded to the histological type of ductal, Lobular type 1/15, 3/15 ductolobulillar and other histological Variant 2/15. CONCLUSIONS: Mucinous carcinoma is a rare variant of the invasive carcinoma of the breast duct that occurs in older women. It is possible to have a diagnosis and treatment using mammography and histopathological confirmation.

Mucinous Carcinoma with Extensive Signet Ring Cell Differentiation: A Case Report

Breast cancers that present with mucin include mucinous carcinoma and carcinoma with signet ring cell differentiation. The former shows extracellular mucin and the latter shows abundant intracellular mucin. Here, we report a case of breast cancer showing both extracellular mucin and extensive signet ring cell differentiation due to abundant intracellular mucin. Unlike mucinous carcinoma, this case had the features of high-grade nuclear pleomorphism, high mitotic index, estrogen receptor negativity, progesterone receptor negativity, human epidermal growth factor receptor-2 positivity, and ductal type with positivity for E-cadherin. In a case with signet ring cell differentiation, differential diagnosis with metastatic signet ring cell carcinoma of the stomach and colon is essential. In this case, the presence of accompanied ductal carcinoma in situ component and mammaglobin and gross cystic disease fluid protein-15 positivity were findings that suggested the breast as the origin.

MRI Features of Mucinous Breast Carcinoma and the Correlation with Biological Prognostic Factors / 中山大学学报(医学科学版)

[Objective]To explore the MRI features of the mucinous breast carcinoma and the correlation with biological prognos?tic factors.[Methods]MRI features of 35 pure and 15 mixed mucinous carcinomas were retrospectively analyzed. MR images were reviewed for shape,margin,the signal intensity,enhancement patterns of tumors and DWI features. All the patients were detected by immunohistochemical staining with expression of ER,PR,CerbB-2,Ki-67 and Her-2. Correlations between the pure and mixed mucinous breast carcinoma and prognostic factors were analyzed.[Results]16 oval masses(16/35,45.7%)and 10 circular masses (10/35,28.6%)were found in 35 pure mucinous breast carcinomas with clear boundary(26/35,74.3%)and lobulated shape(31/35,88.6%);9 irregular masses(9/15,60%)were found in mixed mucinous breast carcinomas with unclear boundary(13/15, 86.7%). Very high signal intensity on T2-weighted images was found in 33 pure mucinous carcinomas(33/35,94.3%)and 11 mixed mucinous carcinomas showed mixed signal intensity(11/15,73.3%). Early enhancement rate was(114.7 ± 9.1)% for pure muci?nous carcinomas and(165.6 ± 14.3)%for mixed mucinous carcinomas. 28 pure mucinous tumors demonstrated persistent enhancing pattern on time-signal intensity curve ,7 pure mucinous tumors demonstrated plateau pattern and 7 mixed mucinous carcinomas showed plateau pattern and washout pattern respectively. Mean ADC value was(1.91 ± 0.06)×10-3 mm2/s for pure mucinous carcino?mas and(1.13±0.08)×10-3mm2/s for mixed mucinous carcinomas. There was significant difference with morphology,boundary,T2WI signal,early enhancement rate,time-signal intensity curve,ADC value between pure and mixed mucinous breast carcinoma(P <0.05). There was significant difference between pure and mixed mucinous breast carcinoma with Her-2 and Ki-67 expression(P <0.05).[Conclusion]MRI could identify PMBC and MMBC from the shape,the signal intensity,dynamic enhancement and ADC val?ue,and PMBC had distinctive MRI features. The prognosis of MMBC is worse than that of PMBC form correlation between biological prognostic factors and mucinous breast carcinoma.

Primary Cutaneous Mucinous Carcinoma of the Eyelid

Primary cutaneous mucinous carcinoma (PCMC) is a rare low-grade malignant neoplasm derived from the eccrine glands. PCMC most commonly arises in the head and neck, with the eyelid being the most common site of origin. This case report describes a 51-year-old male with a painless, pigmented superficial nodular lesion over his right lower eyelid. The lesion was considered to be benign, and the initial treatment was simple excision with a 3-mm margin. However, histologic examination revealed the diagnosis of PCMC, and the patient underwent re-excision of the tumor site with an additional 3-mm margin from the initial scar. Histologic study of this second margin was free of any malignant cells. The patient experienced no postoperative complication or recurrence after 2 years. In our case, the skin lesion had benign morphologic findings and was strongly suspected to be a benign mass. Physicians should be aware of this tumor and be able to differentiate it from benign cystic or solid eyelid lesions.

Primary Cutaneous Mucinous Carcinoma of the Eyelid

Primary cutaneous mucinous carcinoma (PCMC) is a rare low-grade malignant neoplasm derived from the eccrine glands. PCMC most commonly arises in the head and neck, with the eyelid being the most common site of origin. This case report describes a 51-year-old male with a painless, pigmented superficial nodular lesion over his right lower eyelid. The lesion was considered to be benign, and the initial treatment was simple excision with a 3-mm margin. However, histologic examination revealed the diagnosis of PCMC, and the patient underwent re-excision of the tumor site with an additional 3-mm margin from the initial scar. Histologic study of this second margin was free of any malignant cells. The patient experienced no postoperative complication or recurrence after 2 years. In our case, the skin lesion had benign morphologic findings and was strongly suspected to be a benign mass. Physicians should be aware of this tumor and be able to differentiate it from benign cystic or solid eyelid lesions.

Primary Cutaneous Mucinous Carcinoma on the Scalp / 대한피부과학회지

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant tumor believed to originate from the eccrine gland. It is important to exclude other possible origins of the mucinous carcinoma, such as the breast, lung, gastrointestinal tract, kidney, prostate, and ovary, because PCMC generally shows a better prognosis. Some histopathological clues are helpful to distinguish PCMC from metastatic mucinous carcinoma, but the final diagnosis should be made after a thorough systemic evaluation. We report a case of PCMC after a comprehensive evaluation to exclude metastatic mucinous carcinoma.

Primary Cutaneous Mucinous Carcinoma on the Scalp / 대한피부과학회지

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant tumor believed to originate from the eccrine gland. It is important to exclude other possible origins of the mucinous carcinoma, such as the breast, lung, gastrointestinal tract, kidney, prostate, and ovary, because PCMC generally shows a better prognosis. Some histopathological clues are helpful to distinguish PCMC from metastatic mucinous carcinoma, but the final diagnosis should be made after a thorough systemic evaluation. We report a case of PCMC after a comprehensive evaluation to exclude metastatic mucinous carcinoma.

Primary Cutaneous Mucinous Carcinoma Treated with Narrow Surgical Margin

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant tumor of eccrine origin. Clinically, the carcinoma presents as a solitary, slow growing, and painless nodule. For this reason, this tumor is often considered to be a benign mass in the preoperative setting. The lesion is, however, malignant in nature and has a tendency for local recurrence and infrequent metastasis. Wide local excision is the treatment of choice. However, few reports exist with information regarding surgical margins and clinical outcomes. Herein, we report a case of PCMC excised with a narrow surgical margin and review the relevant literature. A 49-year-old man presented with a small cutaneous nodule of the right cheek. The mass was excised without any margin, but pathologic examination revealed histology of mucinous carcinoma. Because of this, the operative site was re-excised with a 5-mm margin, and the wound was closed using a V-Y advancement flap. Systemic work-up did not reveal other potential metastatic primary, for a final diagnosis of PCMC. We report this case of PCMC, treated with relatively narrow margin in a patient with good prognostic factors.

Fine-Needle Aspiration Cytology Findings of Mucinous Carcinoma of Breast.

Pure mucinous carcinoma (MC) of the breast is a relatively uncommon variant of breast carcinoma with distinctive histological and cytological features. Knowledge of the distinctive cytomorphological appearance of MC would enable correct identification of these lesions as malignant and prompt treatment that could further enhance the survival of these prognostically good breast cancers.

Micropapillary Pattern: An Aggressive Component in Pure Mucinous Carcinomas of Breast.

Mucinous micropapillary carcinoma of the breast also described as pure mucinous carcinoma with micropapillary pattern has recently come to attention as an unusual form of invasive breast cancer exhibiting dual mucinous and micropapillary diff erentiation. A 70-year-old lady presented with a complaint of a left breast palpable mass detected 4 months earlier. A fi rm well-defi ned mass of size 4 cm × 3 cm was noted with a small focal ulceration. Her past medical records and family history non-contributory. Ultrasonography revealed a well-defi ned lobulated hypoechoic lesion. Micropapillary pattern being an aggressive counterpart in pure mucinous breast carcinoma. It has increased propensity for lymph node metastasis, so it should recognized by characteristic cytological features and histological findings.

Mucinous precursor lesions of mucinous carcinoma in breast: Incidence and histopathologic features / 고신대학교의과대학학술지

OBJECTIVES: Columnar cell lesion (CCL), atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS) may be premalignant lesion of mammary invasive carcinoma. A few recent investigators reported that the precursor lesions exhibited mucin production and they might be potential precursor lesion for mucinous carcinoma (mCA). This study aims to investigate the incidence and histopathologic characteristics of mucinous precursor lesions, including mucinous DCIS (mDCIS) and mucinous CCL (mCCL). METHODS: We retrospectively analyzed invasive carcinomas with mucin. Cases were grouped into three subgroups: pure mCA, mixed mCA, and invasive carcinoma of no special type with mucin production (IC of NST-m). Precursor lesions were evaluated with PAS and alcian blue staining. RESULTS: Total 27 cases of invasive carcinoma with mucin were analysed and classified as 18 pure mCA, 7 mixed mCA, and 2 IC of NST-m. mDCISs were found in 12 pure mCA, 4 mixed mCA and 2 IC of NST-m. mCCLs were found in 7 pure mCA and 2 mixed mCA. Majority of mucin was identified in both cytoplasm and ductal lumen, while some tumors exhibited only cytoplasmic mucin. We also observed three patterns of mDCIS classifiable by location of mucin and architecture of tumor cells. CONCLUSIONS: Cytoplasmic mucin suggested that mucinous feature of precursor lesions in the vicinity of mCA might not be a passive morphologic finding but be involved in development of mCA.

A Case of Recurrent Primary Mucinous Carcinoma of the Skin / 대한피부과학회지

No abstract available.