Aetiology

Pancreatic MCNs share many features with their counterparts in the liver and retroperitoneum, including their morphology and their almost exclusive occurrence in women {328, 2139, 404, 2198}. The possible derivation of the stromal component of MCNs from the ovarian pri-mordium is supported by morphology, tendency to undergo luteinization, presence of hilar-like cells, and immunophe-notypic sex cord-stromal differentiation. It has been hypothesized that ectopic ovarian stroma incorporated during embryogenesis in the pancreas, along the biliary tree or in the retroperitoneum may release hormones and growth factors causing nearby epithelium to proliferate and form cystic tumours {2198}. Since the left primordial gonad and the dorsal pancreatic anlage lie side by side during the fourth and fifth weeks of development, this hypothesis could explain

Fig. 10.16 Mucinous cystic neoplasm in the tail of the pancreas. The thick wall shows focal calcification.

the predilection of MCN for the body-tail region of the pancreas {1977}.

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