Medical Molecular Morphology

, Volume 43, Issue 4, pp 235–240

A case of splenic low-grade mucinous cystadenocarcinoma resulting in pseudomyxoma peritonei

  • Chisato Ohe
  • Noriko Sakaida
  • Yasuaki Yanagimoto
  • Hideyoshi Toyokawa
  • Sohei Satoi
  • A. -Hon Kwon
  • Chika Tadokoro
  • Kosho Takasu
  • Yoshiko Uemura
Original Paper

Abstract

Primary splenic mucinous cystadenocarcinoma (MCCa) is extremely rare, and only six cases appear to have been reported previously. We present herein a case of primary splenic MCCa resulting in pseudomyxoma peritonei (PMP). A 66-year-old Japanese woman presented to a hospital with a chief complaint of upper abdominal pain and a 7-year history of splenic cyst. Cyst rupture was noted on computed tomography, and splenectomy was performed. The abdominal cavity was filled with a large amount of gelatinous ascites, with the appearance of PMP. On the cut surface, multiple cysts containing mucinous material were found within and outside the spleen. Microscopically, splenic parenchyma was occupied by large mucinous pools focally lined with mucinous epithelial cells and mesothelial cell-like cells, which were considered benign. Outside the spleen, a low-grade MCCa component was found. No ectopic pancreatic or intestinal tissue was identified. Although most PMP cases are known to be caused by low-grade mucinous appendiceal tumor, the present case represents the first report of a splenic MCCa resulting in PMP.

Key words

Mucinous cystadenocarcinoma Spleen Pseudomyxoma peritonei 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Shuman RL, Bouterie RL (1976) Cystadenocarcinoma of the pancreas presenting as a splenic cyst. Surgery (St. Louis) 80:652–654Google Scholar
  2. 2.
    Matsumoto M, Kawamura Y, Ishiguro M, Nagai T (1981) Cystadenocarcinoma of the pancreas manifested as a splenic cyst. Acta Pathol Jpn 31:1089–1096PubMedGoogle Scholar
  3. 3.
    Morinaga S, Ohyama R, Koizumi J (1992) Low-grade mucinous cystadenocarcinoma in the spleen. Am J Surg Pathol 16:903–908CrossRefPubMedGoogle Scholar
  4. 4.
    Zanetti G, Riccioni L, Gallo C, Salfi N, Martinelli GN (1998) Splenic mucinous cystadenocarcinoma arising in heterotopic pancreatic tissue. Tumori 84:606–610PubMedGoogle Scholar
  5. 5.
    Hirota M, Hayashi N, Tomioka T, Murakami S, Ohshima H, Yamasaki K, Miyamoto J, Tamiya S, Ogawa M (1999) Mucinous cystadenocarcinoma of the spleen presenting a point mutation of the Kirsten-ras oncogene at codon 12. Dig Dis Sci 44:768–774CrossRefPubMedGoogle Scholar
  6. 6.
    Nisar PJ, Zaitoun AM, Lobo DN, Rowlands BJ (2002) Heterotopic pancreas in the spleen: malignant degeneration to mucinous cystadenocarcinoma. Eur J Gastroenterol Hepatol 14:793–796CrossRefPubMedGoogle Scholar
  7. 7.
    Shinohara T, Misawa K, Sano H, Okawa Y, Takada A (2006) Pseudomyxoma peritonei due to mucinous cystadenocarcinoma in situ of the urachus presenting as an inguinal hernia. Int J Clin Oncol 11:416–419CrossRefPubMedGoogle Scholar
  8. 8.
    Roulet F (1938) Uber das Pseudomyxoma peritonei e Processu vermiformi. Schweiz Med Wochenschr 29:849–852Google Scholar
  9. 9.
    Mets T, VanHove W, Louis H (1977) Pseudomyxoma peritonei. Report of a case with extraperitoneal metastasis and invasion of the spleen. Chest 72:792–794CrossRefPubMedGoogle Scholar
  10. 10.
    Holder PD, Fehir KM, Schwarts MR, Smigocki G, Madewell JE (1989) Primary mucinous cystadenocarcinoma of the appendix with pseudomyxoma peritonei manifested as a splenic mass. South Med J 82:1029–1031PubMedGoogle Scholar
  11. 11.
    Karak PK, Vashisht S, Berry M (1991) Pseudomyxoma peritonei with splenic invasion. Trop Gastroenterol 12:195–198PubMedGoogle Scholar
  12. 12.
    Ii K, Hirano M, Yamaguchi N, Tsunetomi N, Hino S, Nakagawa H, Tsuda T (1997) A case of pseudomyxoma peritonei of appendiceal origin that metastasized to the spleen and complicated secondary systemic amyloidosis. Nippon Shokakibyo Gakkai Zasshi 94:757–761PubMedGoogle Scholar
  13. 13.
    Du Plessis DG, Louw JA, Wranz PA (1999) Mucinous epithelial cysts of the spleen associated with pseudomyxoma peritonei. Histopathology (Oxf) 35:551–557CrossRefGoogle Scholar
  14. 14.
    Dedic N, Premuzic M, Cavka S, Ostojic R, Hrstic I, Vucelic B (2000) Pseudomyxoma peritonei associated with splenic mucinous epithelial cysts: case report. Lijec Vjesn 122:272–275PubMedGoogle Scholar
  15. 15.
    Shimoyama S, Kuramoto S, Kawahara M, Yamasaki K, Endo H, Murakami T, Kaminishi M (2001) A rare case of pseudomyxoma peritonei presenting an unusual inguinal hernia and splenic metastasis. J Gastroenterol Hepatol 16:825–829CrossRefPubMedGoogle Scholar
  16. 16.
    Ough YD, Nash HR, Wood DA (1981) Mesothelial cysts of the spleen with squamous metaplasia. Am J Clin Pathol 76:666–669PubMedGoogle Scholar
  17. 17.
    Ordonez NG (2003) The immunohistochemical diagnosis of mesothelioma: a comparative study of epithelioid mesothelioma and lung adenocarcinoma. Am J Surg Pathol 27:1031–1051CrossRefPubMedGoogle Scholar
  18. 18.
    Kachali C, Eltoum I, Hortin D, Chhieng DC (2006) Use of mesothelin as a marker for mesothelial cells in cytologic specimens. Semin Diagn Pathol 23:20–24CrossRefPubMedGoogle Scholar
  19. 19.
    Chu PG, Schwarz RE, Lau SK, Yen Y, Weiss LM (2005) Immunohistochemical staining in the diagnosis of pancreatobiliary and ampulla of Vater adenocarcinoma: application of CDX2, CK17, MUC1, and MUC2. Am J Surg Pathol 29:359–367CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Society for Clinical Molecular Morphology 2010

Authors and Affiliations

  • Chisato Ohe
    • 1
  • Noriko Sakaida
    • 1
  • Yasuaki Yanagimoto
    • 2
  • Hideyoshi Toyokawa
    • 2
  • Sohei Satoi
    • 2
  • A. -Hon Kwon
    • 2
  • Chika Tadokoro
    • 1
  • Kosho Takasu
    • 1
  • Yoshiko Uemura
    • 1
  1. 1.Department of Surgical PathologyKansai Medical University, Hirakata HospitalOsakaJapan
  2. 2.Department of SurgeryKansai Medical University, Hirakata HospitalOsakaJapan

Personalised recommendations