El presente trabajo es un estudio correlacional de tipo retrospectivo, de casos y controles, siendo 39 pacientes con cáncer colorrectal del tipo histológico mucinoso los que conforman el grupo de los casos y dos grupos de 117 pacientes cado uno, el primero de pacientes con cáncer colorrectal de otro tipo histológico y el segundo de pacientes con patología digestiva benigna, que conforman los controles; coleccionados entre los años 2002 y 2008 en el Hospital Nacional Edgardo Rebagliati Martins. Se determinó la asociación de los factores de riesgo como: la edad, el género, de riesgo el consumo de tabaco, el consumo de alcohol, la irradiación pélvica, la colecistectomía, el tipo de dieta, la obesidad, otros tipos de cáncer previos, la raza, algunas características clínicopatológicas tales como: la localización del tumor, el grado de diferenciación, el estadio de la enfermedad al momento del diagnóstico y la respuesta al tratamiento recibido; y el cáncer colorrrectal de tipo histológico mucinoso. Al analizar las varaibles mencionadoas se determino que la edad cada vez mayor es una factor de riesgo asociado con mayor probabilidad de cáncer no mucinoso, en tanto la variable obesidad es un factor asociado con mayor probabilidad al cáncer mucinoso. En cuanto a la localización del tumor existe asociación entre el cáncer colorrectal de tipo histológico mucinoso y la localización proximal del colon. El grado de diferenciación moderado y el estadio IIA se encontraron con más frecuencia en este estudio. La sobrevida para los tumores de tipo mucinoso es menor que para los otros tipos histológicos a pesar que la diferencia no llegue a ser significativa.

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Resumo: O carcinoma mucinoso da mama é um tipo histológico raro e de prognóstico favorável, sendo classificado em puro e misto. A proposta deste trabalho foi estudar os aspectos anatomoclínicos do carcinoma mucinoso da mama, identificando os fatores prognósticos nos tipos puros e mistos. Foi conduzido estudo clínico, descritivo e transversal, tendo como base de dados os prontuários e respectivos laudos de carcinoma mucinoso de mama, arquivados no Instituto Brasileiro de Controle do Câncer (IBCC) no período 1990-2005. Por meio de protocolo foram avaliados: idade, menopausa, paridade, antecedentes, estadiamento, tempo de seguimento, tipo de cirurgia, adjuvância, tamanho do tumor, linfonodos, assim como o intervalo livre de doença (ILD) e a sobrevida global. Na análise estatística foram empregados teste t-student, teste do Qui-Quadrado ou Exato de Fisher e o teste de Wilcoxon. Resultados: Dos 71 casos analisados, 44 foram classificados como carcinomas mucinosos puros (CMP) e 27, como mistos (CMM). O tempo médio de seguimento foi 59,25 meses (1-155meses). O CMP associou-se a maior faixa etária quando comparado ao CMM (69,2±13 vs 58,7±17anos) (p<0,05). Quanto ao estadiamento clínico, 31,8% das pacientes com CMP estavam no estádio IIA, enquanto 51,8% daquelas com CMM encontravam-se no estádio IIB. Na avaliação da axila evidenciou-se metástase em 27,8% dos CMP e em 76% dos CMM (p=0,0001)). Não houve diferença quanto à sobrevida e ao ILD entre o CMP e o CMM. No CMP observou-se correlação negativa entre a celularidade e o ILD. No CMM, a correlação entre o percentual de mucina e o ILD foi positiva. Conclusões: O carcinoma mucinoso do tipo puro associou-se a maior faixa etária e menor comprometimento...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Mucinous breast cancer is a rare histologic type with a favorable prognosis. It is classified into pure (PMC) and mixed (MMC). The purpose of this study is to assess the clinicopathological characteristics of this tumor and identify prognostic features in pure and mixed subtypes. It was conducted a descriptive, transverse, clinical study in the Brazilian Institute of Control of the Cancer's (IBCC) database between 1990-2005. The protocol included: age at diagnosis, age of menarche and menopause, number of pregnancies, family history of breast cancer, clinical stage, follow up, surgery, adjuvant therapy, tumor size, nodal status, disease free survival and overall survival. In the statistical analysis, were used t-student test, chi-square test or Fisher's exact test and Wilcoxon test. Out of 71 cases analysed; 44 were classified as pure mucoid carcinoma and 27, as mixed mucoid carcinoma. The mean follow up was 59,25months (range 1-155months) Pure mucinous carcinoma was more prevalent in older patients than the mixed subtype (69,2±13 vs 58,7±17years)(p<0,05). About clinical stage, 31,8% of the PMCs were in IIA stage and 51,8% of the MMCs were in IIB stage. Axillary nodal metastases were present in 27,8% of the PMCs and 76% of the MMCs (p= 0,0001). There was no difference in relapse-free and overall survival between pure and mixed tumors. In the PMCs was found a negative correlation between cellularity and relapse-free; and in the MMCs the correlation between mucoid component and relapse-free was positive. Conclusions: The PMC presented in older patients and axillary nodal disease was less frequent than in MMC, showing a better prognosis. / Orientador: Eliana Aguiar Petri Nahás / Coorientador: Heloísa M. De Luca Vespoli / Banca: José Costa de Andrade / Banca: Mariângela Esther Alencar Marques / Mestre

Intraductal papillary mucinous neoplasms (IPMN) are pancreatic lesions with uncertain biologic behavior. This study sought objective, accurate prediction tools, through the use of quantitative histopathological signatures of nuclear images, for classifying lesions as chronic pancreatitis (CP), IPMN, or pancreatic carcinoma (PC). Forty-four pancreatic resection patients were retrospectively identified for this study (12 CP; 16 IPMN; 16 PC). Regularized multinomial regression quantitatively classified each specimen as CP, IPMN, or PC in an automated, blinded fashion. Classification certainty was determined by subtracting the smallest classification probability from the largest probability (of the three groups). The certainty function varied from 1.0 (perfectly classified) to 0.0 (random). From each lesion, 180 +/- 22 nuclei were imaged. Overall classification accuracy was 89.6% with six unique nuclear features. No CP cases were misclassified, 1/16 IPMN cases were misclassified, and 4/16 PC cases were misclassified. Certainty function was 0.75 +/- 0.16 for correctly classified lesions and 0.47 +/- 0.10 for incorrectly classified lesions (P = 0.0005). Uncertainty was identified in four of the five misclassified lesions. Quantitative histopathology provides a robust, novel method to distinguish among CP, IPMN, and PC with a quantitative measure of uncertainty. This may be useful when there is uncertainty in diagnosis.

Made available in DSpace on 2014-06-11T19:26:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-02-11Bitstream added on 2014-06-13T20:34:10Z : No. of bitstreams: 1 leal_mcp_me_botfm.pdf: 514001 bytes, checksum: 434ae161b1627657b9cfcf9702582fd3 (MD5) / O carcinoma mucinoso da mama é um tipo histológico raro e de prognóstico favorável, sendo classificado em puro e misto. A proposta deste trabalho foi estudar os aspectos anatomoclínicos do carcinoma mucinoso da mama, identificando os fatores prognósticos nos tipos puros e mistos. Foi conduzido estudo clínico, descritivo e transversal, tendo como base de dados os prontuários e respectivos laudos de carcinoma mucinoso de mama, arquivados no Instituto Brasileiro de Controle do Câncer (IBCC) no período 1990-2005. Por meio de protocolo foram avaliados: idade, menopausa, paridade, antecedentes, estadiamento, tempo de seguimento, tipo de cirurgia, adjuvância, tamanho do tumor, linfonodos, assim como o intervalo livre de doença (ILD) e a sobrevida global. Na análise estatística foram empregados teste t-student, teste do Qui-Quadrado ou Exato de Fisher e o teste de Wilcoxon. Resultados: Dos 71 casos analisados, 44 foram classificados como carcinomas mucinosos puros (CMP) e 27, como mistos (CMM). O tempo médio de seguimento foi 59,25 meses (1-155meses). O CMP associou-se a maior faixa etária quando comparado ao CMM (69,2±13 vs 58,7±17anos) (p<0,05). Quanto ao estadiamento clínico, 31,8% das pacientes com CMP estavam no estádio IIA, enquanto 51,8% daquelas com CMM encontravam-se no estádio IIB. Na avaliação da axila evidenciou-se metástase em 27,8% dos CMP e em 76% dos CMM (p=0,0001)). Não houve diferença quanto à sobrevida e ao ILD entre o CMP e o CMM. No CMP observou-se correlação negativa entre a celularidade e o ILD. No CMM, a correlação entre o percentual de mucina e o ILD foi positiva. Conclusões: O carcinoma mucinoso do tipo puro associou-se a maior faixa etária e menor comprometimento... / Mucinous breast cancer is a rare histologic type with a favorable prognosis. It is classified into pure (PMC) and mixed (MMC). The purpose of this study is to assess the clinicopathological characteristics of this tumor and identify prognostic features in pure and mixed subtypes. It was conducted a descriptive, transverse, clinical study in the Brazilian Institute of Control of the Cancer`s (IBCC) database between 1990-2005. The protocol included: age at diagnosis, age of menarche and menopause, number of pregnancies, family history of breast cancer, clinical stage, follow up, surgery, adjuvant therapy, tumor size, nodal status, disease free survival and overall survival. In the statistical analysis, were used t-student test, chi-square test or Fisher`s exact test and Wilcoxon test. Out of 71 cases analysed; 44 were classified as pure mucoid carcinoma and 27, as mixed mucoid carcinoma. The mean follow up was 59,25months (range 1-155months) Pure mucinous carcinoma was more prevalent in older patients than the mixed subtype (69,2±13 vs 58,7±17years)(p<0,05). About clinical stage, 31,8% of the PMCs were in IIA stage and 51,8% of the MMCs were in IIB stage. Axillary nodal metastases were present in 27,8% of the PMCs and 76% of the MMCs (p= 0,0001). There was no difference in relapse-free and overall survival between pure and mixed tumors. In the PMCs was found a negative correlation between cellularity and relapse-free; and in the MMCs the correlation between mucoid component and relapse-free was positive. Conclusions: The PMC presented in older patients and axillary nodal disease was less frequent than in MMC, showing a better prognosis.

Objective: To report experience with borderline ovarian tumors (BOTs) in a developing country like Pakistan with limited resources and weak database of health system. Methods: Patients with BOTs managed at Shaukat Khanum Cancer hospital, Lahore, Pakistan from 2004 to 2014 were included and reviewed retrospectively. Data was recorded on histopathological types, age, CA-125, stage of disease, treatment modalities and outcomes. Results: Eighty-six patients with BOT were included with a median age of 35 years. Forty-two (49%) patients had serous BOTs and 43 (50%) had mucinous BOTs, while one (1%) had mixed type. Using FIGO staging, 80 patients had stage I; two patients had IIA, IIB and stage III each. Median follow-up time was 31.5 months. All patients had primary surgery. Seventy (81%) patients underwent complete surgical resection of tumor. Forty-three (50%) patients had fertility preserving surgery. Seventy-three (85%) patients remained in remission. Recurrent disease was observed in 13 (15%) patients. Median time to recurrence was 22 months. On further analysis, age above forty years, late stage at diagnosis and incomplete surgery were significantly associated with invasive recurrence. Conclusion: Despite a low malignant potential, relapses may occur in patients above forty years of age, incomplete surgery and staging information and advanced stage at presentation. Fertility sparing surgery should be considered in young patients. Complete excision of tumor and prolonged follow-up are advised because recurrence and transformation to invasive carcinoma may occur.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20224号 / 医博第4183号 / 新制||医||1019(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 増永 慎一郎, 教授 武藤 学, 教授 羽賀 博典 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

NTRODUÇÃO: Neoplasias mucinosas primárias do ovário apresentam muitos pontos de controvérsias em relação ao seu padrão de diferenciação, sendo classificadas como tumores benignos, borderline e malignos.Elas também são classificadas em diferentes fenótipos, recentemente designadas como gastrointestinal e seromucinoso. Sua heterogeneidade tem produzido não somente dificuldades na classificação morfológica e no diagnóstico diferencial com neoplasias metastáticas, mas também na compreensão da patogênese e na interpretação imunoistoquímica. O fenótipo gastrointestinal tem sido pouco explorado em relação a possíveis diferenças entre os padrões de diferenciação gástrico e intestinal, desde que os dois são geralmente analisados juntos. Os tumores mucinosos borderline, considerado um estágio precoce da carcinogênese dos tumores mucinosos, são freqüentemente associados com pseudomixoma peritoneal (PMP), o qual foi recentemente relacionado a neoplasias mucinosas do apêndice cecal. O propósito deste estudo foi analizar os diferentes padrões morfológicos de apresentação dos tumores mucinosos do ovário e sua associação com o potencial de malignidade e o perfil imunoistoquímico. MATERIAL E MÉTODOS: Este estudo retrospectivo incluiu 72 tumores de 63 pacientes com diagnóstico patológico presumido de tumor mucinoso primário de ovário selecionados dos arquivos da Divisão de Patologia Cirúrgica da Faculdade de Medicina da Universidade de São Paulo, de 1996 a 2005. Todos as lâminas da população de pacientes foram revisadas e classificadas de acordo com os critérios da WHO. Marcação imunoistoquímica para produtos do gene de mucina (MUC1, MUC2, MUC5AC e MUC6), RE, RP, CK7, CK20, CA19.9 e CA125 foram feitos em tissue microarrays. RESULTADOS: Nossos resultados mostraram 28 tumores benignos, 35 borderline e 9 malignos distribuídos nos fenótipos: pilórico (11), intestinal (30), gastrointestinal (20), mülleriano (4) e misto (gastrointestinal e mülleriano) (7). Seis pacientes tinham PMP associados. O estudo imunoistoquímico foi realizado em 67 tumores. Os tumores pilóricos apresentaram-se mais freqüentemente como tumores benignos (72.7%) e tiveram um perfil imunoistoquímico diferente de MUC2 (p= 0.003) e CA19.9 (p= 0.04) quando comparado com o fenótipo intestinal. MUC1 foi mais expresso entre os tumores com diferenciação mülleriana (pura ou mista) (100%, p= 0.02) quando comparado aos tumores de outros fenótipos. Os receptores hormonais foram positivos somente no fenótipo mülleriano. Os tumores borderline foram mais freqüentes nos fenótipos intestinal e gastrointestinal (37.1% e 40%), e estavam associados a PMP em 25% dos casos. Todos os tumores ovarianos associados a PMP eram de tipo histológico borderline e com fenótipo intestinal. O perfil dos tumores borderline de tipo intestinal, mesmo nos casos sem PMP, foi distinto dos outros tumores mucinosos de tipo intestinal e caracterizado pela expressão XVII de MUC2 e CK20. A média de idade das pacientes com tumores borderline de tipo intestinal sem PMP foi menor que daquelas com PMP. CONCLUSÃO: O subgrupo de tumores mucinosos de ovário de fenótipo gastrointestinal é o mais freqüente, mas é hetetogênio e composto por uma população de células de tipos pilórico e intestinal que diferem entre si em relação ao potencial de malignidade e perfil imunoistoquímico. Os tumores de fenotipo intestinal são mais freqüentemente malignos e borderline. Os tumores ovarianos associados com PMP e provavelmente também a maioria dos tumores borderline de fenótipo intestinal, mesmo sem PMP, devem ser considerados como tumores secundários, quando uma origem em apêndice cecal parece a mais provável. / NTRODUCTION: Primary ovarian neoplasms of mucinous type carry many controversial points regarding their pattern of differentiation, classified as benign, borderline and malignant tumors. They are also classified into different morphological phenotypes, recently called as gastrointestinal and seromucinous. Their heterogeneity has produced not only difficulty into morphological classification and differential diagnostic with metastatic neoplasms, but also on understanding the pathogenesis and immunohistochemical interpretation. The gastrointestinal phenotype has been little explored with respect to possible differences between the gastric and intestinal morphological patterns of differentiation, since the two have generally been analyzed together. The mucinous borderline tumors, thought to be an intermediary stage of mucinous carcinogenesis, were frequently associated with pseudomyxoma peritonei (PMP), which was recently linked to appendiceal mucinous neoplasms. The purpose of the study was to analyze the different morphological patterns of presentation of mucinous ovarian tumors and their association with malignant potential and immunohistochemical profile. MATERIAL AND METHODS: This retrospective study included 72 tumors from 63 patients with pathological diagnosis of presumed primary mucinous ovarian tumor selected from the files of the Division of Surgical Pathology of University of Sao Paulo Medical School, from 1996 to 2005. All slides from the patient cohort were reviewed and classified according to WHO criteria. Immunohistochemical staining for mucin genes products (MUC1, MUC2, MUC5AC and MUC6), ER, PR, CK7, CK20, CA19.9 and CA125 were performed in tissue microarrays. RESULTS: Our results showed 28 benign, 35 borderline and 9 malignant tumors distributed in phenotypes: pyloric (11), intestinal (30), gastrointestinal (20), müllerian (4) and mixed (7) gastrointestinal and müllerian). Six patients had PMP associated. The immunohistochemical study was performed in 67 tumors. The pyloric tumors presented more frequently as benign tumors (72.7%) and had a differential immunohistochemical profile of MUC2 (p= 0.003) and CA19.9 (p= 0.04) when compared with intestinal phenotype. MUC1 was more expressed between tumors with müllerian differentiation (pure or mixed) (100%, p= 0.02) when compared with the others. The hormonal receptors were positive only in müllerian phenotype. Borderline tumors were more frequently of intestinal and gastrointestinal phenotypes (37.1% and 40%), and were associated to PMP in 25% of the cases. All ovarian tumors associated to PMP were of borderline histology and of intestinal type. The profile of intestinal borderline tumors, even in cases without PMP, was distinct from that of other primary mucinous tumors of the intestinal type and characterized by MUC2 and CK20 expression. The median age of patients with intestinal borderline tumors without PMP was lower than those with PMP. XIX CONCLUSION: The gastrointestinal subgroup of mucinous ovarian tumors is the more frequent, but it is heterogeneous and composed of pyloric, and intestinal cell population that differ regarding malignant potential and immunoprofile. The intestinal tumors are more frequently malignant and borderline. Ovarian tumors associated with PMP and probably most intestinal borderline tumors, even without PMP, should be considered as secondary tumor when the appendiceal origin seems the most probable.

NTRODUÇÃO: Neoplasias mucinosas primárias do ovário apresentam muitos pontos de controvérsias em relação ao seu padrão de diferenciação, sendo classificadas como tumores benignos, borderline e malignos.Elas também são classificadas em diferentes fenótipos, recentemente designadas como gastrointestinal e seromucinoso. Sua heterogeneidade tem produzido não somente dificuldades na classificação morfológica e no diagnóstico diferencial com neoplasias metastáticas, mas também na compreensão da patogênese e na interpretação imunoistoquímica. O fenótipo gastrointestinal tem sido pouco explorado em relação a possíveis diferenças entre os padrões de diferenciação gástrico e intestinal, desde que os dois são geralmente analisados juntos. Os tumores mucinosos borderline, considerado um estágio precoce da carcinogênese dos tumores mucinosos, são freqüentemente associados com pseudomixoma peritoneal (PMP), o qual foi recentemente relacionado a neoplasias mucinosas do apêndice cecal. O propósito deste estudo foi analizar os diferentes padrões morfológicos de apresentação dos tumores mucinosos do ovário e sua associação com o potencial de malignidade e o perfil imunoistoquímico. MATERIAL E MÉTODOS: Este estudo retrospectivo incluiu 72 tumores de 63 pacientes com diagnóstico patológico presumido de tumor mucinoso primário de ovário selecionados dos arquivos da Divisão de Patologia Cirúrgica da Faculdade de Medicina da Universidade de São Paulo, de 1996 a 2005. Todos as lâminas da população de pacientes foram revisadas e classificadas de acordo com os critérios da WHO. Marcação imunoistoquímica para produtos do gene de mucina (MUC1, MUC2, MUC5AC e MUC6), RE, RP, CK7, CK20, CA19.9 e CA125 foram feitos em tissue microarrays. RESULTADOS: Nossos resultados mostraram 28 tumores benignos, 35 borderline e 9 malignos distribuídos nos fenótipos: pilórico (11), intestinal (30), gastrointestinal (20), mülleriano (4) e misto (gastrointestinal e mülleriano) (7). Seis pacientes tinham PMP associados. O estudo imunoistoquímico foi realizado em 67 tumores. Os tumores pilóricos apresentaram-se mais freqüentemente como tumores benignos (72.7%) e tiveram um perfil imunoistoquímico diferente de MUC2 (p= 0.003) e CA19.9 (p= 0.04) quando comparado com o fenótipo intestinal. MUC1 foi mais expresso entre os tumores com diferenciação mülleriana (pura ou mista) (100%, p= 0.02) quando comparado aos tumores de outros fenótipos. Os receptores hormonais foram positivos somente no fenótipo mülleriano. Os tumores borderline foram mais freqüentes nos fenótipos intestinal e gastrointestinal (37.1% e 40%), e estavam associados a PMP em 25% dos casos. Todos os tumores ovarianos associados a PMP eram de tipo histológico borderline e com fenótipo intestinal. O perfil dos tumores borderline de tipo intestinal, mesmo nos casos sem PMP, foi distinto dos outros tumores mucinosos de tipo intestinal e caracterizado pela expressão XVII de MUC2 e CK20. A média de idade das pacientes com tumores borderline de tipo intestinal sem PMP foi menor que daquelas com PMP. CONCLUSÃO: O subgrupo de tumores mucinosos de ovário de fenótipo gastrointestinal é o mais freqüente, mas é hetetogênio e composto por uma população de células de tipos pilórico e intestinal que diferem entre si em relação ao potencial de malignidade e perfil imunoistoquímico. Os tumores de fenotipo intestinal são mais freqüentemente malignos e borderline. Os tumores ovarianos associados com PMP e provavelmente também a maioria dos tumores borderline de fenótipo intestinal, mesmo sem PMP, devem ser considerados como tumores secundários, quando uma origem em apêndice cecal parece a mais provável. / NTRODUCTION: Primary ovarian neoplasms of mucinous type carry many controversial points regarding their pattern of differentiation, classified as benign, borderline and malignant tumors. They are also classified into different morphological phenotypes, recently called as gastrointestinal and seromucinous. Their heterogeneity has produced not only difficulty into morphological classification and differential diagnostic with metastatic neoplasms, but also on understanding the pathogenesis and immunohistochemical interpretation. The gastrointestinal phenotype has been little explored with respect to possible differences between the gastric and intestinal morphological patterns of differentiation, since the two have generally been analyzed together. The mucinous borderline tumors, thought to be an intermediary stage of mucinous carcinogenesis, were frequently associated with pseudomyxoma peritonei (PMP), which was recently linked to appendiceal mucinous neoplasms. The purpose of the study was to analyze the different morphological patterns of presentation of mucinous ovarian tumors and their association with malignant potential and immunohistochemical profile. MATERIAL AND METHODS: This retrospective study included 72 tumors from 63 patients with pathological diagnosis of presumed primary mucinous ovarian tumor selected from the files of the Division of Surgical Pathology of University of Sao Paulo Medical School, from 1996 to 2005. All slides from the patient cohort were reviewed and classified according to WHO criteria. Immunohistochemical staining for mucin genes products (MUC1, MUC2, MUC5AC and MUC6), ER, PR, CK7, CK20, CA19.9 and CA125 were performed in tissue microarrays. RESULTS: Our results showed 28 benign, 35 borderline and 9 malignant tumors distributed in phenotypes: pyloric (11), intestinal (30), gastrointestinal (20), müllerian (4) and mixed (7) gastrointestinal and müllerian). Six patients had PMP associated. The immunohistochemical study was performed in 67 tumors. The pyloric tumors presented more frequently as benign tumors (72.7%) and had a differential immunohistochemical profile of MUC2 (p= 0.003) and CA19.9 (p= 0.04) when compared with intestinal phenotype. MUC1 was more expressed between tumors with müllerian differentiation (pure or mixed) (100%, p= 0.02) when compared with the others. The hormonal receptors were positive only in müllerian phenotype. Borderline tumors were more frequently of intestinal and gastrointestinal phenotypes (37.1% and 40%), and were associated to PMP in 25% of the cases. All ovarian tumors associated to PMP were of borderline histology and of intestinal type. The profile of intestinal borderline tumors, even in cases without PMP, was distinct from that of other primary mucinous tumors of the intestinal type and characterized by MUC2 and CK20 expression. The median age of patients with intestinal borderline tumors without PMP was lower than those with PMP. XIX CONCLUSION: The gastrointestinal subgroup of mucinous ovarian tumors is the more frequent, but it is heterogeneous and composed of pyloric, and intestinal cell population that differ regarding malignant potential and immunoprofile. The intestinal tumors are more frequently malignant and borderline. Ovarian tumors associated with PMP and probably most intestinal borderline tumors, even without PMP, should be considered as secondary tumor when the appendiceal origin seems the most probable.

El adenocarcinoma mucinoso de apéndice es una neoplasia poco frecuente con una tasa de incidencia de 0,08% de todas las neoplasias. El diagnóstico suele hacerse por biopsia ya que por su presentación clínica puede simular otras patologías de estructuras localizadas en cuadrante abdominal inferior derecho. Actualmente el tratamiento aún es controversial siendo la cirugía la mejor opción. El presente reporte describe un paciente con antecedentes de apendicectomía hace 27 años que actualmente acude con una tumoración dolorosa en fosa ilíaca derecha asociada a un antígeno carcinoembrionario de 138 ng/dl. / Mucinous adenocarcinoma of the appendix is a rare neoplasm with an incidence rate of 0.08% of all malignancies. The diagnosis is usually made by biopsy because its clinical presentation may mimic other diseases of structures located in the right lower quadrant. Currently, the treatment is still controversial, being surgery the best option. This report describes a patient with a history of appendectomy 27 years ago that is hospitalized for a painful mass in the lower abdomen associated with carcinoembryonic antigen of 138 ng/dl.