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Low grade appendiceal mucinous neoplasm

Yeqian Huang, Nayef A Alzahrani, Winston Liauw, Thamer B Traiki, David L Morris
BACKGROUND: There is little evidence for the use of early postoperative intraperitoneal chemotherapy (EPIC) in patients with low-grade appendiceal mucinous neoplasms (LAMNs) with pseudomyxoma peritonei (PMP). This study aims to assess the outcomes regarding the use of EPIC in a large cohort of patients with LAMNs with PMP uniformly treated by cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy (PIC), all of whom received hyperthermic intraperitoneal chemotherapy (HIPEC), and most of whom also received EPIC...
October 7, 2016: Annals of Surgical Oncology
Byeong-Joo Noh, Youn Wha Kim, Yong-Koo Park
Heterotopic ossification occurring to low-grade appendiceal mucinous neoplasm (LAMN) (pseudomyxoma peritonei) is extremely rare. The pathogenetic mechanism of the tumor-related heterotopic bone formation remains as yet unconfirmed. Here, we describe a rare case of LAMN with ossification in a 72-year-old woman, and concentrate on the etiology of heterotopic ossification by the immunohistochemical evaluation of the novel markers such as BMP9, osteocalcin, and osteopontin. BMP9 is one of the most effective osteogenetic proteins...
September 22, 2016: Pathology, Research and Practice
Miroslav Sekulic, Simona Pichler Sekulic, Saeid Movahedi-Lankarani
Low-grade appendiceal mucinous neoplasm is a neoplasm typically of appendiceal origin, which is characterized by diffuse peritoneal involvement by pools of mucin with mucinous epithelium lacking high-grade cytologic atypia, and clinically presents as suspected peritoneal carcinomatosis. A similar clinical presentation can sometimes be seen with disseminated low-grade serous carcinomas of the peritoneum, fallopian tubes, or ovaries; however, this neoplasm is histologically characterized by tubal-type epithelium and invasive or confluent growth...
September 28, 2016: International Journal of Gynecological Pathology
Keith Fournier, Safia Rafeeq, Melissa Taggart, Paul Kanaby, Jing Ning, Hsiang-Chun Chen, Michael Overman, Kanwal Raghav, Cathy Eng, Paul Mansfield, Richard Royal
BACKGROUND: Low-grade appendiceal mucinous neoplasm of uncertain malignant potential are poorly understood lesions characterized by extraluminal mucin or fibrosis with neoplastic cells confined to the appendiceal lumen. The purpose of this study is to investigate the clinical and pathologic parameters of these lesions to optimize our understanding and management of these tumors. METHODS: Subjects with these tumors were identified from the appendiceal tumor databases at the University of Texas MD Anderson Cancer Center...
September 22, 2016: Annals of Surgical Oncology
Eisar Al-Sukhni, Charles LeVea, Joseph Skitzki, John Kane, Valerie Francescutti
INTRODUCTION: The prognosis of appendiceal mucinous neoplasms (AMN) is directly related to their histopathology. Existing classification schemes encompass tumors with widely divergent clinical behaviors within a single diagnosis, making it difficult for clinicians to interpret pathology reports to counsel patients on optimal management. We sought to examine pathology reports generated for AMN for inclusion of essential histologic features. METHODS: Pathology reports of appendectomy specimens with a diagnosis of AMN (2002-2015) at our center ("internal") and from referring institutions ("external") were retrospectively reviewed for inclusion of the following 5 essential items: layer of invasion, mucin dissection (low grade neoplasms only), perforation, margins, and serosal implants...
October 2016: Annals of Diagnostic Pathology
Jason M Foster, Richard L Sleightholm, Steve Wahlmeier, Brian Loggie, Poonam Sharma, Asish Patel
BACKGROUND: Disseminated peritoneal adenomucinosis (DPAM) patients often have a history of appendectomy with identification of an incidental mucinous neoplasm (low-grade appendiceal mucinous neoplasm (LAMN)). The rate of developing DPAM is not well established. METHODS: Twenty-two patients with incidental LAMN were identified and monitored with cancer markers and CT every 4-6 months. Laparoscopy with peritoneal washing was performed in patients either in the event of radiographic disease or after 12 months in absence of radiographic disease...
2016: World Journal of Surgical Oncology
Hamad Hadi Al-Qahtani, Saleh Asalamah, Mohammed Akeely, Salman Mohammad Alshakaki
Pseudomyxoma retroperitonei is a rare condition, characterized by accumulation of mucinous material in the retroperitoneal space, originating predominantly from the appendiceal mucinous neoplasms. A72-year-old male patient presented with a history of progressive right side abdominal pain for 5 months with a palpable abdominal mass. Ultrasound, computerized tomography, and magnetic resonance imaging showed large right abdominal multiloculated cystic lesion with heterogeneous echoic contents. Colonoscopy revealed normal mucosa with extramural pressure on the right colon and cecum...
June 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Xianyong Gui, Ziran Meng, Yarrow J McConnell, Shuhong Liu, Vincent G Falck, Lloyd A Mack, Walley J Temple
BACKGROUND: Tumours of appendix, including classic carcinoid tumour (CCT), goblet cell carcinoid (GCC), low-grade appendiceal mucinous neoplasm, high-grade appendiceal mucinous neoplasm/mucinous carcinoma (MCA) and non-mucinous adenocarcinoma (NMA), show different and sometimes mixed morphological features. It was hypothesised that these tumours originate from common tumour stem cell(s) with potential of various cell lineage differentiation. In normal intestinal epithelium, absorptive lineage (enterocytes) differentiation is driven by Notch-Hes1 pathway, while secretory lineage is driven by Wnt-Math1 pathway and further separated by different downstream signallings into three sublineages (Gfi1-Klf4/Elf3 for goblet cells, Gfi1-Sox9 for Paneth cells and Ngn3-Pdx1/Beta2/Pax4 for enteroendocrine cells)...
July 1, 2016: Journal of Clinical Pathology
Ayako Ito, Yuma Sakura, Mikio Sugimoto, Yoshiyuki Kakehi, Naoto Kuroda
Mucinous neoplasms of the urinary tract are very rare. We present a 63-year-old-women who had a sessile papillary villous tumor in urinary bladder. Although transurethral resection of the bladder tumor (TURBT) was performed, the villous tumor repetitively recurred and gradually spread to the entire surface of bladder lumen. Histopathologic and immunohistochemical examination showed that the lesion was very similar to low-grade mucinous neoplasm arising in appendix vermiformis. There are no reports on appendiceal metaplasia of urinary bladder mucosa...
May 2016: Urology Case Reports
S Y Choi, S Park, K H Kim, S H Kim
Heterotopic bone formation is a very rare event in the gastrointestinal tract including in the appendix. Here we report three cases of heterotopic ossification in appendiceal mucinous neoplasms, one occurring in an appendiceal mucinous cystadenoma, another in a low-grade appendiceal mucinous neoplasm, and the third occurring in an appendiceal mucinous adenocarcinoma. The clinicopathologic characteristics of these three present cases and two previously reported cases are discussed in detail. The mechanism of heterotopic ossification in appendiceal mucinous neoplasm is still unclear, but mucin extravasation and subsequent calcification may be predisposing events...
April 2016: Malaysian Journal of Pathology
Ioannis Kehagias, Apollon Zygomalas, Georgios Markopoulos, Thanasis Papandreou, Pantelis Kraniotis
Appendiceal mucocele is a rare cause of acute abdomen. Mucinous appendiceal neoplasms represent 0.2-0.7% of all appendix specimens. The aim of this study is to report a case of a mucinous appendiceal neoplasm presented as acute appendicitis, discussing the clinical and surgical approach in the emergency setting. A 72-year-old female patient was admitted to the emergency department with a clinical examination indicative of acute abdomen. The patient underwent abdominal computed tomography scan which revealed a cystic lesion in the right iliac fossa measuring 8...
2016: Case Reports in Oncological Medicine
Veena Ramaswamy
Neoplasms of the appendix are rare, but because of their unusual presentation and unpredictable biologic behavior, it is important to diagnose them correctly. Mucinous tumors account for 58 % of malignant tumors of appendix in SEER database and the remaining are carcinoids. The mucinous appendiceal tumors have a potential to spread to the peritoneum and viscera in the form of gelatinous material with or without neoplastic cells resulting in Pseudomyxoma peritonei. (PMP) PMP is a clinical entity that has a unique biological behavior and can arise from seemingly benign tumors to frankly malignant ones...
June 2016: Indian Journal of Surgical Oncology
Hiroshi Nagata, Yuji Kondo, Kazushige Kawai, Soichiro Ishihara, Shinsuke Kazama, Takako Nirei, Daisuke Soma, Jun Yamada, Eiji Sunami, Joji Kitayama, Yoshiro Kubota, Toshiaki Watanabe
BACKGROUND: Mucinous cystadenocarcinoma is the second most common etiology of appendiceal mucocele. We report a relatively rare case of a giant appendiceal mucocele caused by mucinous cystadenocarcinoma, which occupied the entire abdomen of an adult woman. CASE PRESENTATION: A 63-year-old woman presented with a chief complaint of abdominal distention. Imaging studies showed a giant cystic mass occupying her entire abdomen. Laparotomy confirmed a giant appendiceal mucocele, and the patient underwent ileocecal resection...
2016: World Journal of Surgical Oncology
Terence C Chua, Preetjote Gill, Anthony J Gill, Jaswinder S Samra
Mucinous appendiceal neoplasm occurs in less than 1% of appendicectomies. Majority of what is known in the literature is about pseudomyxoma peritonei, which exists as its disseminated form. Pictorial imagery of its pre-disseminated form is rarely observed. We present in a case report form a case of low-grade mucinous neoplasm of the appendix resulting in focal intussusception including images captured from this unique case that will become a learning case for readers of the journal.
April 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Malin Enblad, Helgi Birgisson, Alkwin Wanders, Filip Sköldberg, Lana Ghanipour, Wilhelm Graf
BACKGROUND: The importance of absent neoplastic epithelium in specimens from cytoreductive surgery (CRS) is unknown. This study aimed to investigate the prevalence and prognostic value of histopathology without neoplastic epithelium in patients treated with CRS and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Data were extracted from medical records and histopathology reports for patients treated with initial CRS and HIPEC at Uppsala University Hospital, Sweden, between 2004 and 2012...
April 2016: Annals of Surgical Oncology
Michelle Moh, Gregor Krings, Deniz Ates, Anil Aysal, Grace E Kim, Joseph T Rabban
The primary origin of some ovarian mucinous tumors may be challenging to determine, because some metastases of extraovarian origin may exhibit gross, microscopic, and immunohistochemical features that are shared by some primary ovarian mucinous tumors. Metastases of primary colorectal, appendiceal, gastric, pancreatic, and endocervical adenocarcinomas may simulate primary ovarian mucinous cystadenoma, mucinous borderline tumor, or mucinous adenocarcinoma. Recently, immunohistochemical expression of SATB2, a transcriptional regulator involved in osteoblastic and neuronal differentiation, has been shown to be a highly sensitive marker of normal colorectal epithelium and of colorectal adenocarcinoma...
March 2016: American Journal of Surgical Pathology
Sarah Strickland, Carlos Parra-Herran
AIMS: The distinction between primary ovarian mucinous tumours and appendiceal mucinous neoplasms metastatic to the ovary can be challenging, given the overlap of morphological features and immunohistochemical expression of traditional markers. Special AT-rich sequence-binding protein 2 (SATB2) has recently been described as a sensitive and specific marker of colorectal epithelium. This study was to determine its expression in appendiceal mucinous tumours and its role in their distinction from ovarian neoplasms...
June 2016: Histopathology
Norman J Carr, Thomas D Cecil, Faheez Mohamed, Leslie H Sobin, Paul H Sugarbaker, Santiago González-Moreno, Panos Taflampas, Sara Chapman, Brendan J Moran
Pseudomyxoma peritonei (PMP) is a complex disease with unique biological behavior that usually arises from appendiceal mucinous neoplasia. The classification of PMP and its primary appendiceal neoplasia is contentious, and an international modified Delphi consensus process was instigated to address terminology and definitions. A classification of mucinous appendiceal neoplasia was developed, and it was agreed that "mucinous adenocarcinoma" should be reserved for lesions with infiltrative invasion. The term "low-grade appendiceal mucinous neoplasm" was supported and it was agreed that "cystadenoma" should no longer be recommended...
January 2016: American Journal of Surgical Pathology
Daniel Alin Cristian, Florin Andrei Grama, Gabriel Becheanu, Anamaria Pop, Ileana Popa, Valeriu Şurlin, Sorin Stănilescu, Ana Magdalena Bratu, Traean Burcoş
We present a rare case of malignant epithelial neoplasm of the appendix, an uncommon disorder encountered in clinical practice, which poses a variety of diagnostic and therapeutic challenges. We report a particular case in which the appendix was abnormally located in the pelvis, mimicking an adnexal mass. Therefore, it was difficult to make the preoperative diagnosis on clinical examination, imaging studies and laboratory tests and we discovered the lesion during the diagnostic laparoscopy. No lymphadenopathy or mucinous ascites were found...
2015: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Kazuyoshi Nakatani, Katsuji Tokuhara, Tatsuma Sakaguchi, Hironori Ryota, Kazuhiko Yoshioka, Masanori Kon
INTRODUCTION: Low-grade mucinous neoplasia is an uncommon benign tumor that develops in the appendix. The development of mucocele disease has never been reported in a colonic diverticulum. We present a case developing low-grade mucinous neoplasia in a cecal diverticulum. PRESENTATION OF CASE: A tumor in the ileocecal region was found during a medical examination of a 66-year-old woman. Three months later, the tumor was still present and the patient developed abdominal pain...
2015: International Journal of Surgery Case Reports
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