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WHO Classification of Tumours
Mucinous adenocarcinoma
Pancreas


Definition

An invasive adenocarcinoma composed of malignant glandular cells which contain intracytoplasmic mucin. Often, the infiltrating glandular structures are associated with mucoid stromal formation.

Mucoid adenocarcinoma / Colloid carcinoma of the pancreas
Colloid carcinoma is an infiltrating ductal epithelial neoplasm of the pancreas characterized by the presence, in at least 80% of the neoplasm, of large extracellular stromal mucin pools containing suspended neoplastic cells

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Adsay NV, Pierson C, Sarkar F, Abrams J, Weaver D, Conlon KC, Brennan MF, Klimstra DS (2001)
Colloid (mucinous noncystic) carcinoma of the pancreas.
Am J Surg Pathol 25: 26-42



. Colloid carcinomas tend to be large and well-demarcated and almost always arise in association with an intestinal-type intraductal papillary mucinous neoplasm (IPMN)
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Seidel G, Zahurak M, Iacobuzio-Donahue C, Sohn TA, Adsay NV, Yeo CJ, Lillemoe KD, Cameron JL, Hruban RH, Wilentz RE (2002)
Almost all infiltrating colloid carcinomas of the pancreas and periampullary region arise from in situ papillary neoplasms: a study of 39 cases.
Am J Surg Pathol 26: 56-63



. The large pools of mucin are partially lined by well-differentiated cuboidal to columnar neoplastic cells and contain clumps or strands of neoplastic cells. Some floating cells may be of the signet-ring type. The neoplastic cells of colloid carcinoma show intestinal differentiation; there is strong expression of CDX2 and MUC2, which are not significantly expressed in conventional ductal adenocarcinoma.
Two features help to distinguish benign spillage of mucin into the extraductal stroma caused by rupture of the dilated pancreatic duct occupied by an IPMN from true tissue invasion by a colloid carcinoma. Neoplastic cells “floating” in pools of stromal mucin, and neoplastic cells in an abnormal location, such as in the perineurium, help identify the lesion as a colloid carcinoma. In contrast, benign mucin spillage will consist of mucus lakes adjacent to a pancreatic branch duct without “floating” neoplastic cells.
Pseudomyxoma peritonei can be a rare complication of this carcinoma. Colloid carcinomas seem to have a more favourable prognosis than conventional ductal adenocarcinomas

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Poultsides GA, Reddy S, Cameron JL, Hruban RH, Pawlik TM, Ahuja N, Jain A, Edil BH, Iacobuzio-Donahue CA, Schulick RD, Wolfgang CL (2010)
Histopathologic basis for the favorable survival after resection of intraductal papillary mucinous neoplasm-associated invasive adenocarcinoma of the pancreas.
Ann Surg 251: 470-6




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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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