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WHO Classification of Tumours
Mucinous adenocarcinoma
Region of the ampulla of Vater


Definition

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

Mucinous adenocarcinoma of the ampulla of Vater
Approximately 5% of the ampullary carcinomas in the SEER database are mucinous adenocarcinomas

Click to access Pubmed
Albores-Saavedra J, Schwartz AM, Batich K, Henson DE (2009)
Cancers of the ampulla of vater: demographics, morphology, and survival based on 5,625 cases from the SEER program.
J Surg Oncol 100: 598-605



. The diagnosis of mucinous adenocarcinoma requires that > 50% of the tumour should be composed of stromal mucin that contains small groups of malignant epithelial cells, epithelial strips or ruptured cystically dilated glands. The strips and glands are lined by columnar cells with an intestinal phenotype, whereas the cells arranged in small groups or clusters may have a signet-ring cell morphology.

Some mucinous adenocarcinomas are associated with a component of intestinal adenocarcinoma, a noninvasive papillary neoplasm or an intestinal-type adenoma. Extensive sampling may be needed to demonstrate the neoplastic cells in the mucin pools of some mucinous adenocarcinomas. Some intestinal-type adenocarcinomas contain a focal mucinous component, which is insufficient to classify the tumour as a mucinous adenocarcinoma. Since the vast majority of mucinous adenocarcinomas of the ampulla express the intestinal markers CDX2 and MUC2, these tumours are regarded as variants of intestinal-type adenocarcinomas.

The prognosis for patients with ampullary mucinous carcinomas is not better than for those with intestinal- or pancreatobiliary-type adenocarcinomas

Click to access Pubmed
Albores-Saavedra J, Schwartz AM, Batich K, Henson DE (2009)
Cancers of the ampulla of vater: demographics, morphology, and survival based on 5,625 cases from the SEER program.
J Surg Oncol 100: 598-605



, in contrast to mucinous carcinomas of the breast and pancreas, and their corresponding ductal carcinomas
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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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