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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.
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.
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.
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, Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells, Invasive carcinoma arising in an intraductal papillary mucinous neoplasm (IPMN-associated carcinoma), Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma (MCN-associated carcinoma), Solid pseudopapillary neoplasm of the pancreas
Nothing recorded yet.
Nothing recorded yet.
Also on OnCo: Symptoms and red flags · Early detection roadmap.
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.
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.
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Query for this cancer: (TITLE:"Colloid mucinous non-cystic carcinoma of the pancreas" OR ABSTRACT:"Colloid mucinous non-cystic carcinoma of the pancreas" OR TITLE:"Colloid mucinous non-cystic carcinoma of the pancreas mucin pools; usually the invasive part of an intestinal-type IPMN; better outlook" OR ABSTRACT:"Colloid mucinous non-cystic carcinoma of the pancreas mucin pools; usually the invasive part of an intestinal-type IPMN; better outlook" OR TITLE:"Colloid carcinoma of the pancreas" OR ABSTRACT:"Colloid carcinoma of the pancreas" OR TITLE:"Mucinous non-cystic carcinoma of the pancreas" OR ABSTRACT:"Mucinous non-cystic carcinoma of the pancreas" OR TITLE:"Mucinous noncystic carcinoma" OR ABSTRACT:"Mucinous noncystic carcinoma" OR TITLE:"Colloid carcinoma" OR ABSTRACT:"Colloid carcinoma") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Colloid (mucinous non-cystic) carcinoma of the pancreas, not a curated reading list.
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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
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