Uterus
Carcinoma
Mucinous Carcinoma

Author: Mohamed Mokhtar Desouki, M.D., Ph.D. (see Authors page)

Revised: 25 January 2017, last major update August 2011

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed search: mucinous [title] carcinoma uterus

Cite this page: Mucinous Carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/uterusmucinous.html. Accessed May 25th, 2017.
Definition / general
  • Adenocarcinoma with abundant intracellular mucin
  • May have enteric features
  • May have a microglandular pattern with eosinophilic, mucinous intraluminal secretion and acute inflammation, simulating microglandular hyperplasia
  • Mucin should be a predominant component of the tumor since scattered mucin is present in ordinary endometrial adenocarcinoma
  • Mucinous carcinomas may be primed by exogenous estrogen therapy
Epidemiology
  • Rare tumor (< 1% of endometrial carcinomas, up to 9% of stage I endometrial carcinomas) that affects patients 47 - 89 years
Etiology
  • Unknown
Clinical features
  • Most patients are menopausal and present with vaginal bleeding, usually not abdominal pain
  • Both nulliparous and multiparous women
Prognostic factors
Treatment
  • TAH / BSO then possible radiation (for advanced disease) for disease limited to the uterus (NCCN Guidelines Version 1.2014); consideration of preoperative radiation for tumors grossly involving the cervix before doing surgery (this is uncommon)
Gross description
  • Similar to other low grade adenocarcinomas at gross examination; may not be grossly apparent
  • Visible tumors vary from sessile polyps to nodules or irregular, thickened plaques that may be localized or diffuse
Microscopic (histologic) description
  • Intracellular (not intraluminal) mucin is required for diagnosis; best demonstrated with mucicarmine or other mucin stain; however, mucin is easily visible with H&E staining
  • Malignant features include architectural complexity of proliferation, epithelial stratification, loss of epithelial polarity, nuclear atypicality (Am J Surg Pathol 1983;7:715)
  • Microglandular pattern and intestinal differentiation with goblet cells are different variants
  • Low grade tumors also occur (Am J Surg Pathol 2011;35:537)
Microscopic (histologic) images

Images hosted on PathOut server:

This invasive adenocarcinoma
contains abundant mucin both
within lumina and in the cyto-
plasm of the glandular cells

Irregular, confluent malignant
glands are lined by well
differentiated cells containing
intracytoplasmic mucin

Cytology description
  • Tumor cells arranged in papillary configuration and tumor cell clusters with bubbles in cytoplasm
Positive stains
Differential diagnosis