Mucinous Cystic Neoplasm : Clinical

Comments:
Clinical Features of Mucinous Cystic Neoplasm (MCN): About 95% of MCNs arise in women with a mean age at diagnosis of 48 years (range 14-95 years). Patients with an associated invasive carcinoma component are 5-10 years older. It is uncommon in postmenopausal women and quite rare in men.

Larger tumors cause a palpable mass and produce symptoms due to compression of adjacent structures. About 70% of patients give history of abdominal pain or fullness and weight loss. Since the tumors do not communicate with the pancreatic duct system, they are less likely than intraductal papillary mucinous neoplasms to cause pancreatitis or jaundice. However, acute pancreatitis does occur in about 9% of cases due to extrinsic compression of the pancreatic duct. Fatigue, weight loss, a palpable abdominal mass, and new-onset diabetes are more likely associated with malignant MCNs.

Between 25-30% of cases (generally smaller than 3 cm) are asymptomatic and found incidentally on abdominal imaging performed for other indications. Serum CA19-9 levels may be elevated. Fluid aspirated from cysts contains high levels of CEA.

This low magnification view of a MCN shows a multilocular cyst with thick septations.