Not true about mucinous cystadenoma pancreas?
Correct Answer: Microcystic adenoma
Description: Ans is 'a' i.e. Microcystic adenoma Mucinous cystadenoma are macrocystic adenomas. Serous cystadenomas are microcystic adenomas. Cystic neoplasm of Pancreas Cystic neoplasms are of the following types: Common types? a. Serous cystadenomas (approx. 25-30% of all cystic neoplasms) b. Mucinous cystadenomas and cystadenocarcinomas (approx 40-50% of all cystic neoplasms) Uncommon types? c. intraductal papillary mutinous tumor (approx.10% of all cystic neoplasms) solid pseudopapillary neoplasm (about 5-10% of all cystic neoplasms) Serous cystadenomas Serous cystadenomas are benign tumors without malignant potential. (Serous cystadenocarcinoma has been repoed very rarely (<1%) They have a spongy appearance, composed of multiple small cysts (microcystic). May contain central stellate fibrotic scar that may calcify (sunburst calcification) and it is highly specific and considered to be viually pathognomonic of serous cystadenoma. The cyst is lined by simple cuboidal epithelium. They do not produce mucin These lesions thus contain thin serous fluid that does not stain positive for mucin and is low in CEA ( Common in females (F:M ratio is 2:1), usually in 7th decade of life. Common in the head/ uncinate process region.(50% in the head/uncinate process, and 50% in the neck, body, or tail) Serous cystadenomas do not have malignant potential, hence operated only when symptomatic. Mucionous cystic neoplasms (cystadenoma and cystadenocarcinoma) Mucinous cystic neoplasms (MCNs) encompass a spectrum ranging from benign but potentially malignant (i.e. cystadenomas) to carcinoma with a very aggressive behavior (i.e. cystadenocarcinomas); suggesting a gradual malignant transformation. MCNs are composed of large thick-walled, septate cysts (macrocystic) with no connection to the ductal system. (difference from IPMN where tumor is connected to the ductal system) The cysts are lined by tall columnar epithelium that fills the cyst with viscous mucin. MCNs are characterised by the presence of ovarian-type stroma which is a key pathologic feature distinguishing these lesions. This stroma is not only morphologically similar to that of the ovarian coex, but also expresses oestrogen and progesterone receptors that are detectable by immunohistochemistry Females are much more commonly affected than males (ratio 9:1), with mean age of 50 years. MCNs predominantly involve the body and tail of the pancreas. High CEA levels in the fluid (>200 ng/mL) may suggest malignant transformation. Resection is the treatment of choice for MCNs as the best way to distinguish the entirely benign form (mucinous cystadenoma) from its malignant counterpa (mucinous cystadenocarcinoma) is pathologic assessment after complete surgical removal. Because most MCNs are located in the body and tail of the pancreas, distal pancreatectomy is the most common treatment. IPMNs IPMNs are similar to MCNs in that they are cystic tumors that secrete mucin. The epithelial lining of the cyst is by tall columnar mucin producing cells that frequently forms papillary projections. Two major differences from MCNs is: - IPMNs extensively involve the main pancreatic ducts or the major side branches (or both); whereas MCNs do not connect to the pancreatic duct system. - IPMNs lack the 'ovarian' stroma seen in MCNs. Mucin production by cells leads to intraductal mucin accumulation and subsequent cystic dilation. This mucin production may be so great that mucin can be seen extruding from the ampulla of Vater. On ERCP, mucin can be seen extruding from the ampulla of Vater, a so-called fish-eye lesion, that is viually diagnostic of IPMN Like MCNs IPMNs can range from benign (IPMN adenomas) to malignant (IPMN carcinomas) In contrast to mucinous cystic neoplasms, IPMNs arise more frequently in men than in women, and they involve the head of the pancreas more often than the tail. Age group: seventh to eighth decade of life Surgery is the treatment of choice. Solid- Pseudopapillary tumor Solid-pseudopapillary tumors are rare and typically occur in young women These are well encapsulated, typically large lesions (>10 cm), and may occur anywhere within the pancreas.
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