What are the findings and management of mucinous cystadenoma?

From the Guidelines

Mucinous cystadenomas are typically managed with surgical resection due to their growth potential and risk of malignant transformation, with complete surgical excision being curative and having excellent prognosis and low recurrence rates. The diagnosis of mucinous cystadenomas relies on imaging studies such as ultrasound, CT, or MRI, which show a multilocular cystic lesion with thin septations, followed by histopathological confirmation.

• The management of mucinous cystadenomas involves:
  • Surgical resection for ovarian mucinous cystadenomas, with treatment options including cystectomy or oophorectomy depending on patient age and fertility desires 1
  • Distal pancreatectomy or enucleation for pancreatic mucinous cystadenomas 1
• The distinction from mucinous cystadenocarcinoma is important, as the latter requires more aggressive surgical management and possible adjuvant therapy 1
• Regular follow-up with imaging is recommended for any residual disease to monitor for potential recurrence or malignant transformation 1
• The use of biomarkers such as CEA and CA19-9 in cyst fluid may aid in the diagnosis and differentiation of mucinous cystadenomas from other pancreatic cystic lesions, but their sensitivity and specificity are limited 1
• Recent guidelines recommend complete surgical resection of mucinous cystic neoplasms of the liver, with enucleation with free margins considered an option for centrally located tumors 1

From the Research

Findings of Mucinous Cystadenoma

• Benign mucinous cystadenomas account for 15% of all ovarian neoplasms and up to 80% of all mucinous tumors 2
• Mucinous cystic neoplasm (MCN) of the pancreas is characterized by mucin-producing columnar epithelium and dense ovarian-type stroma and is at risk for malignant transformation 3
• Tumor size, age, and serum levels of tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and CA12-5 may contribute to the management of patients with MCN 3
• Ovarian masses larger than 100 pounds are rarely encountered in developed countries given advancements in early diagnosis and treatment 4

Management of Mucinous Cystadenoma

• Laparoscopy has become an accepted method of management for ovarian cysts and its role is expanding as large benign adnexal masses more than 10 cm can be managed safely and effectively 2
• Surgical resection is the primary treatment modality for mucinous cystadenoma and cystadenocarcinoma 3
• A multidisciplinary approach in the preoperative, intraoperative, and postoperative stages of management optimizes patient outcomes 4
• Appendectomy is not a necessary adjunctive procedure in the surgical treatment of benign ovarian mucinous cystadenomas, especially if the tumor is larger than 10-12 cm and with normal peritoneal and appendiceal gross morphology 5
• Laparoscopic resection is a viable option for the removal of massive ovarian mucinous cystadenoma 6