# Colloid (mucinous non-cystic) carcinoma of the pancreas

Source: https://onco.cc/cancers/pancreatic-colloid-carcinoma/  
OnCo record `pancreatic-colloid-carcinoma` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Colloid carcinoma is a rare form of pancreatic cancer in which the cancer cells float in large pools of mucus rather than forming glands in dense scar. It usually grows out of an intestinal-type IPMN in the main pancreatic duct, presents as a larger but lower-stage tumour, and has a clearly better outlook after surgery than ordinary pancreatic cancer.

## Summary

What it is. Colloid carcinoma is defined by nodular pools of extracellular mucin containing scanty malignant cells, making up more than 80 percent of the tumour (Adsay 2001); the 2019 WHO classification lists it as a variant of ductal adenocarcinoma (Nagtegaal 2020). In more than half of the defining series it was the invasive component of an IPMN (9 of 17) or an MCN (1 of 17), and KRAS codon 12 mutations were found in only 4 of 12 cases studied, fewer than in ordinary ductal cancer.

How it differs from its parent. Patients present with larger tumours (mean 5.3 cm) but lower stage; two- and five-year survival were 70 and 57 percent against 28 and 12 percent for 82 resectable ordinary ductal adenocarcinomas at the same centre, and ten patients were alive without disease at a median of 79 months, four of them despite lymph node metastases (Adsay 2001). Among invasive IPMNs, colloid and oncocytic carcinomas kept a favourable outcome after stage matching while tubular carcinomas did not; colloid carcinomas arose only from intestinal-type IPMNs and mostly from main-duct disease (Mino-Kenudson 2011), and in a matched series tubular histology carried 3.7 times the hazard of death of colloid histology (Yopp 2011).

How common it is. Not counted by registries; 26 to 41 percent of invasive IPMN-associated cancers in the two single-centre series above.

How it is treated. Resection, usually a pancreatoduodenectomy for main-duct IPMN in the head, with adjuvant chemotherapy as for ductal adenocarcinoma; there is no histology-specific trial. The defining series noted that all seven patients who died with or of tumour had undergone an incisional biopsy before or during surgery, and none of the survivors had, an observation the authors flagged rather than proved.

## Fields

- Kind: Cancer
- Last checked: 2026-09-24
- Also known as: Colloid (mucinous non-cystic) carcinoma of the pancreas (mucin pools; usually the invasive part of an intestinal-type IPMN; better outlook); Colloid carcinoma of the pancreas; Mucinous non-cystic carcinoma of the pancreas; Mucinous noncystic carcinoma; Colloid carcinoma
- Tags: gi; pancreatic; subtype-page
- Group: gastrointestinal
- Burden: Rare: 17 cases with more than 80 percent colloid pattern in the series that defined it; 16 of 61 (26 percent) invasive cancers arising in IPMNs at one centre and 24 of 59 (41 percent) at another were colloid type. No population count is published.
- Subtypes: Colloid carcinoma arising in an intestinal-type IPMN (the usual setting); Colloid carcinoma arising in a mucinous cystic neoplasm; Colloid carcinoma without an identifiable precursor (distinguished from ductal PDAC with mucinous features)
- Biomarkers: More than 80 percent extracellular mucin pools with floating malignant cells (histology); Intestinal-type IPMN background (MUC2 and CDX2 positive); KRAS mutation in a minority (4 of 12 in the defining series)

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/pancreatic-colloid-carcinoma/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/pancreatic-colloid-carcinoma/#overview [1 state-of-the-art points]
- What it is (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/pancreatic-colloid-carcinoma/#what-it-is [3 subtypes]
- Finding it (on the hub): How it shows itself, how it is confirmed, what screening exists, and the biomarkers clinicians test for. https://onco.cc/cancers/pancreatic-colloid-carcinoma/#finding-it [3 biomarkers]
- Treating it (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/pancreatic-colloid-carcinoma/#treating-it [2 settings, 2 decisions with options]
- Evidence (on the hub): Trials recruiting now, the landmark trials, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/pancreatic-colloid-carcinoma/#evidence [2 milestones]
- The science (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/pancreatic-colloid-carcinoma/#science [1 target, 2 pathways]
- Where you are (own page): Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record. https://onco.cc/cancers/pancreatic-colloid-carcinoma/where-you-are/
- Living with it (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/pancreatic-colloid-carcinoma/#living-with-it [12 questions, 2 red cards]
- What is coming (own page): Everything in development, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/pancreatic-colloid-carcinoma/coming/ [2 medicines, 2 open problems]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/pancreatic-colloid-carcinoma/data/ [15 connected records]

## Standard of care

- Resectable: Pancreatoduodenectomy or distal pancreatectomy with the IPMN, followed by adjuvant chemotherapy as for ductal adenocarcinoma; the remaining gland is kept under surveillance because IPMN is a field disease. ([Whipple procedure (pancreaticoduodenectomy)](https://onco.cc/terms/whipple/), [Distal pancreatectomy (removal of the body and tail of the pancreas, usually with the spleen)](https://onco.cc/terms/distal-pancreatectomy/), [FOLFIRINOX / mFOLFIRINOX](https://onco.cc/drugs/folfirinox/), [Neoadjuvant / adjuvant / perioperative](https://onco.cc/terms/neoadjuvant-adjuvant/), [High-risk pancreatic surveillance (CAPS / PRECEDE)](https://onco.cc/technologies/pancreatic-surveillance/))
- Advanced: Treated as pancreatic ductal adenocarcinoma: resection with adjuvant chemotherapy when removable, the chemotherapy rows of the parent page when not; the parent record carries the trials. ([FOLFIRINOX / mFOLFIRINOX](https://onco.cc/drugs/folfirinox/), [Gemcitabine + nab-paclitaxel](https://onco.cc/drugs/gemcitabine-nab-paclitaxel/))

## State of the art

- Recognised since 2001 as a distinct, better-behaved variant; the favourable outcome of invasive IPMN is largely the colloid and oncocytic subtypes.

## Open problems

- Rarity: no trial, no registry code, so its share and outcomes come from single centres.
- Whether the favourable outlook justifies less adjuvant treatment is untested.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Mucinous_carcinoma
- Adsay, Am J Surg Pathol 2001: colloid (mucinous non-cystic) carcinoma of the pancreas: https://doi.org/10.1097/00000478-200101000-00003
- Mino-Kenudson, Gut 2011: prognosis of invasive IPMN depends on histological and precursor epithelial subtypes: https://doi.org/10.1136/gut.2010.232272
- Yopp, Ann Surg 2011: invasive carcinoma arising in IPMN, matched comparison with ductal adenocarcinoma: https://doi.org/10.1097/sla.0b013e318214bcb4
- Nagtegaal, Histopathology 2020: the 2019 WHO classification of tumours of the digestive system: https://doi.org/10.1111/his.13975

## Connected records

- cancers: [Adenosquamous carcinoma of the pancreas](https://onco.cc/cancers/pancreatic-adenosquamous-carcinoma/), [Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors](https://onco.cc/cancers/ipmn-cystic-precursors/), [Invasive carcinoma arising in an intraductal papillary mucinous neoplasm (IPMN-associated carcinoma)](https://onco.cc/cancers/ipmn-associated-carcinoma/), [Mucinous adenocarcinoma of the colon and rectum](https://onco.cc/cancers/colorectal-mucinous-adenocarcinoma/), [Mucinous carcinoma of the gallbladder](https://onco.cc/cancers/gallbladder-mucinous-carcinoma/), [Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma (MCN-associated carcinoma)](https://onco.cc/cancers/mcn-associated-carcinoma/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [High-risk pancreatic surveillance (CAPS / PRECEDE)](https://onco.cc/technologies/pancreatic-surveillance/), [Histopathology & immunohistochemistry](https://onco.cc/technologies/histopathology-ihc/)
- targets: [KRAS](https://onco.cc/targets/kras/)
- drugs: [FOLFIRINOX / mFOLFIRINOX](https://onco.cc/drugs/folfirinox/), [Gemcitabine + nab-paclitaxel](https://onco.cc/drugs/gemcitabine-nab-paclitaxel/)
- pathways: [Pancreatic cancer (KEGG map)](https://onco.cc/pathways/pancreatic-cancer-signalling/), [RAS / RAF / MEK / ERK (MAPK)](https://onco.cc/pathways/ras-mapk/)
- terms: [Distal pancreatectomy (removal of the body and tail of the pancreas, usually with the spleen)](https://onco.cc/terms/distal-pancreatectomy/), [Grade](https://onco.cc/terms/tumour-grade/), [High-risk stigmata and worrisome features of pancreatic cysts (IPMN and MCN surgical criteria)](https://onco.cc/terms/pancreatic-cyst-high-risk-stigmata/), [Neoadjuvant / adjuvant / perioperative](https://onco.cc/terms/neoadjuvant-adjuvant/), [Whipple procedure (pancreaticoduodenectomy)](https://onco.cc/terms/whipple/)

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JSON: https://onco.cc/api/v1/entities/pancreatic-colloid-carcinoma.json