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Case Report
Primary retroperitoneal mucinous cystic tumor with borderline malignancy, microinvasion, and KRAS mutation: A case report
1 Resident, Service of Anatomic Pathology and Cytopathology, University Hospital “Dr. José Eleuterio González”, Monterrey, Nuevo León, Mexico
2 Head of Service and Pathology Professor, Service of Anatomic Pathology and Cytopathology, University Hospital “Dr. José Eleuterio González”, Monterrey, Nuevo León, Mexico
3 Pathology Professor, Service of Anatomic Pathology and Cytopathology, University Hospital “Dr. José Eleuterio González”, Monterrey, Nuevo León, Mexico
Address correspondence to:
Mauricio Gonzalo Alanis Arredondo
Decápolis #805, Col. Jardines de San Agustín, San Pedro Garza García, Nuevo León,
Mexico
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Article ID: 100083Z11MA2024
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Arredondo MGA, Quintana OB, Meza IAO. Primary retroperitoneal mucinous cystic tumor with borderline malignancy, microinvasion, and KRAS mutation: A case report. J Case Rep Images Pathol 2024;10(2):32–37.ABSTRACT
Introduction: Primary retroperitoneal mucinous cystic tumors with borderline malignancy are rare neoplasms of uncertain histopathogenesis with few cases reported in the literature. Histologically, these tumors are an analogous counterpart to the more common ovarian mucinous borderline tumor. A microinvasive component of these neoplasms may contribute to higher probabilities of recurrence and poor prognosis, while the presence of various mutations, particularly in KRAS and GNAS exons, could have therapeutic relevance in the future.
Case Report: Imaging studies of a 42-year-old female with abdominal pain and distension revealed a large abdominopelvic cystic tumor. This tumor was initially misdiagnosed as adnexal. Gynecologic surgery showed the tumor to depend on the retroperitoneum. The patient had intact gynecologic organs. Further, a macroscopic study revealed a cystic cavity filled with serous liquid, with dominant papillary excrescence, and multiple microscopic papillae distributed along the inner lining. Moreover, a histologic analysis showed a proliferation of more than 10% of cylindrical mucosecretory epithelium, with dysplasia and focal infiltration to the stroma. Additionally, the immunohistochemistry revealed diffuse epithelial positivity for CK7 and focal CK20 positivity. Superior and inferior gastrointestinal endoscopies were done, where the possibility of a neoplastic origin in here was ruled out. Next-generation sequencing showed a missense mutation in exon 2 of KRAS.
Conclusion: While the histopathogenesis of primary retroperitoneal mucinous tumors remains uncertain, the overall behavior and prognosis is remarkably similar to their better-known mucinous counterparts in the ovary. The possibility of targeted treatments in cases with malignancy, recurrence, and metastases also remains an important topic in molecular oncology, highlighting the need for further molecular profiling.
Keywords: Borderline, Mucinous, Retroperitoneal, Tumor
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Author Contributions
Mauricio Gonzalo Alanis Arredondo - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Oralia Barboza Quintana - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Itzel Aracely Ortiz Meza - Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Mauricio Gonzalo Alanis Arredondo et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
