Loading
MCN-associated carcinoma is pancreatic cancer that has developed inside a mucinous cystic neoplasm, a thick-walled cyst with ovary-like tissue in its wall that occurs almost only in women, usually in the tail of the pancreas. Most such cysts are benign when removed; the minority with invasive cancer are larger, carry nodules and occur in older women, and about six in ten survive five years.
What it is. A mucinous cystic neoplasm is defined by ovarian-type stroma in the cyst wall and by the absence of communication with the pancreatic duct; the 2019 WHO classification grades it as MCN with low- or high-grade dysplasia or MCN with associated invasive carcinoma (Nagtegaal 2020). The invasive component is usually a tubular ductal adenocarcinoma and occasionally colloid or undifferentiated with osteoclast-like giant cells (Adsay 2001; Muraki 2016).
How it differs from its parent. In 163 resected MCNs defined by ovarian stroma, 95 percent were in women and 97 percent in the distal pancreas; 72 percent were adenomas, 10.5 percent borderline, 5.5 percent carcinoma in situ and 12 percent invasive carcinoma; patients with invasive cancer were older (55 against 44 years); every cancer was 40 mm or larger or had nodules; five-year disease-specific survival was 100 percent for non-invasive and 57 percent for invasive MCNs, and only invasive tumours recurred (Crippa 2008). In 156 Japanese cases, 82.7 percent were adenomas, 13.4 percent non-invasive carcinomas and 3.9 percent invasive; 98.1 percent were women with a mean age of 48, mean size 65 mm, and five- and ten-year survival were 96.6 percent overall, with cyst diameter and mural nodules predicting malignancy (Yamao 2011).
How common it is. Not counted by registries; the shares above come from resected series and understate benign cysts that were never removed.
How it is treated. Because MCNs sit in the body and tail, the operation is usually a distal pancreatectomy with splenectomy, minimally invasive where the DIPLOMA trial has shown the oncological outcome is not inferior for pancreatic cancer (Korrel 2023). Non-invasive MCNs are cured by resection and need no follow-up in the European guidance cited on the parent cyst page; MCN with invasive carcinoma is staged and treated as pancreatic ductal adenocarcinoma with adjuvant chemotherapy. The Japanese series recommended resecting all MCNs, while European guidance allows observation of small MCNs without nodules; both positions are recorded on the parent cyst page.
Invasive carcinoma was present in 12 percent of 163 resected mucinous cystic neoplasms in two European and US centres and 3.9 percent of 156 in Japan; MCNs themselves are uncommon and 95 to 98 percent occur in women, almost all in the body or tail.
Most pancreatic cancers arise in the head next to the bile duct, which is why jaundice is the presenting sign; bile duct cancers are named by where along the tree they sit.
Same organ: Glucagonoma, VIPoma, Somatostatinoma, Pancreatic ductal adenocarcinoma, Biliary tract cancer (cholangiocarcinoma), Intrahepatic cholangiocarcinoma, Extrahepatic cholangiocarcinoma (perihilar and distal), Biliary tract cancer (all types), Neuroendocrine tumours, Pancreatic neuroendocrine tumours, Grade 3 well-differentiated neuroendocrine tumour, Extrapulmonary neuroendocrine carcinoma, Gallbladder cancer, Gallbladder adenocarcinoma, Papillary carcinoma of the gallbladder, Mucinous carcinoma of the gallbladder, Adenosquamous and squamous carcinoma of the gallbladder, Neuroendocrine carcinoma of the gallbladder, Incidental gallbladder cancer (found after cholecystectomy), Carcinoma in situ and dysplasia of the gallbladder, Cystic duct carcinoma, Ampullary cancer (ampulla of Vater), Resectable pancreatic ductal adenocarcinoma, Borderline resectable pancreatic ductal adenocarcinoma, Locally advanced unresectable pancreatic ductal adenocarcinoma, Metastatic pancreatic ductal adenocarcinoma, KRAS G12C-mutant pancreatic ductal adenocarcinoma, KRAS wild-type pancreatic ductal adenocarcinoma, BRCA or PALB2-mutant pancreatic ductal adenocarcinoma, Mismatch repair deficient (MSI-high) pancreatic ductal adenocarcinoma, Pancreatic acinar cell carcinoma, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatoblastoma, Adenosquamous carcinoma of the pancreas, Colloid (mucinous non-cystic) carcinoma of the pancreas, Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells, Invasive carcinoma arising in an intraductal papillary mucinous neoplasm (IPMN-associated carcinoma), Solid pseudopapillary neoplasm of the pancreas
Nothing recorded yet.
Nothing recorded yet.
Also on OnCo: Symptoms and red flags · Early detection roadmap.
Distal pancreatectomy with splenectomy (minimally invasive where expertise exists, DIPLOMA), pancreatoduodenectomy for the rare head lesion; adjuvant chemotherapy as for ductal adenocarcinoma when invasive carcinoma is found.
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.
Country and place are remembered in this browser only. A postcode is sent to OpenStreetMap's Nominatim service to find coordinates when you press the button; nothing else leaves your device.
Query for this cancer: (TITLE:"Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma" OR ABSTRACT:"Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma" OR TITLE:"MCN-associated carcinoma" OR ABSTRACT:"MCN-associated carcinoma" OR TITLE:"Mucinous cystic neoplasm with associated invasive carcinoma women, body and tail; 4 to 12 percent of resected MCNs" OR ABSTRACT:"Mucinous cystic neoplasm with associated invasive carcinoma women, body and tail; 4 to 12 percent of resected MCNs" OR TITLE:"Invasive MCN" OR ABSTRACT:"Invasive MCN" OR TITLE:"Mucinous cystadenocarcinoma of the pancreas" OR ABSTRACT:"Mucinous cystadenocarcinoma of the pancreas" OR TITLE:"MCN with invasive carcinoma" OR ABSTRACT:"MCN with invasive carcinoma") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma (MCN-associated carcinoma), not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Bleeding that will not stop, black or bloody stools, or unexplained bruising when platelets are expected to be low.
The three main regimens share low blood counts, tiredness, sickness and sore mouth; FOLFIRINOX and NALIRIFOX add irinotecan diarrhoea and oxaliplatin's cold-triggered tingling and rare throat spasm, gemcitabine with nab-paclitaxel adds hair loss and neuropathy, and every regimen comes with the same temperature rule for ringing the 24-hour line.
See all on the product pages:FOLFIRINOX / mFOLFIRINOXGemcitabine + nab-paclitaxel·Printable cards in the navigator
Newly diagnosed? Read the first 60 days with Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma, then print the one-page appointment sheet with room for the answers.
Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.
Everything in development, the open problems and what is being done about them, the roadmaps, and what changed on this record.
Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked.