Mucinous rectal cancer: concepts and imaging challenges

  • Natally Horvat
  • Thomas A. Hope
  • Perry J. Pickhardt
  • Iva PetkovskaEmail author
Special Section: Rectal Cancer


Rectal adenocarcinoma with mucinous components is an uncommon type of rectal cancer with two distinct histologic subtypes: mucinous adenocarcinoma and signet-ring cell carcinoma. Mucin can also be identified as pattern of response after neoadjuvant treatment. On imaging modalities, mucin typically demonstrates high signal intensity on T2-weighted images, low attenuation on computed tomography, and may be negative on 18-fluorodeoxyglucose positron emission tomography. After neoadjuvant CRT, cellular and acellular mucin share similar imaging features, and differentiating them is currently the main challenge faced by radiologists. Radiologists should be aware of pros, cons, and limitations of each imaging modality in the primary staging and restaging to avoid misinterpretation of the radiological findings.


Rectal neoplasms Mucin Magnetic resonance imaging Computed tomography Positron emission tomography 



This work was supported in part through the NIH/NCI Cancer Center Support Grant P30 CA008748.

Compliance with ethical standards

Competing interests

The authors have declared that no competing interests exist.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. For this type of study formal consent is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Natally Horvat
    • 1
  • Thomas A. Hope
    • 2
  • Perry J. Pickhardt
    • 3
  • Iva Petkovska
    • 4
    Email author
  1. 1.Department of RadiologyHospital Sirio-LibanesSão PauloBrazil
  2. 2.Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoUSA
  3. 3.Department of RadiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  4. 4.Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkUSA

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