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MUC16 indicates poor prognosis in coexistent pancreatic ductal adenocarcinoma and serous cystadenoma: A case report and review of literature
Ya-Tong Li, Yu-Pei Zhang, Qing-Di Fang, Huan-Wen Wu, Yu Xiao, Wen-Ming Wu, Hua-Dan Xue, Zheng-Yu Jin, Zhi-Wei Wang
Ya-Tong Li, Hua-Dan Xue, Zheng-Yu Jin, Zhi-Wei Wang, Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Yu-Pei Zhang, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Qing-Di Fang, School of Medicine, Tsinghua University, Beijing 100084, China
Huan-Wen Wu, Yu Xiao, Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Wen-Ming Wu, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Co-first authors: Ya-Tong Li and Yu-Pei Zhang.
Author contributions: Li YT and Zhang YP drafted the manuscript as co-first authors; Li YT, Zhang YP, and Fang QD finished data analysis; Li YT and Wang ZW accomplished the study conception and design, and critically revised manuscript; Wu HW, Xiao Y, Wu WM, Xue HD, and Jin ZY finished data acquisition and documentation; Wang ZW was responsible for proofreading and author communication; all the authors approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81903150 and No. 22232006; National Key Research and Development Program of China, No. 2023YFA0915304; and Beijing Natural Science Foundation Program, No. 7194305.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Zhi-Wei Wang, MD, Full Professor, Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Wangfujing Avenue, Beijing 100730, China.
tougaojiayou@aliyun.com
Received: October 16, 2025
Revised: November 7, 2025
Accepted: January 9, 2026
Published online: March 27, 2026
Processing time: 164 Days and 8.7 Hours
BACKGROUND
The coexistence of pancreatic ductal adenocarcinoma (PDAC) and serous cystadenoma (SCN) is an exceedingly uncommon phenomenon.
CASE SUMMARY
A 62-year-old male patient presented to our hospital with a chief complaint of right upper abdominal discomfort. Extensive preoperative imaging examinations consistently indicated a mass located at the pancreatic tail with accompanying pancreatic duct dilation. Initially, an intraductal papillary mucinous neoplasm was suspected. However, intraoperatively, we discovered a mass at the pancreatic head and a mass at the pancreatic tail, and the entire pancreas demonstrated evident atrophy. The pathological analysis revealed the mass at the head to be a PDAC and the mass at the tail to be a SCN. This highlights the potential for a more unfavorable prognosis when both entities coexist compared to PDAC in isolation. Whole-genome sequencing revealed key mutations, including MUC16, TP53, KRAS, CDKN2A, and SMAD4, compared to normal pancreatic tissue from the same patient.
CONCLUSION
MUC16 is associated with poor prognosis in coexistent PDAC and SCN. Moreover, enhancing the precision and accuracy of preoperative imaging diagnoses is of paramount importance, due to the difficulty in differential diagnosis of coexistent pancreatic lesions.
Core Tip: The coexistent pancreatic ductal adenocarcinoma and serous cystadenoma occur rarely, accompanied by challenges in diagnosis. MUC16 is associated with poor prognosis in coexistent pancreatic ductal adenocarcinoma and serous cystadenoma. Enhancing the precision and accuracy of preoperative imaging diagnoses is of paramount importance in the differential diagnosis of coexistent pancreatic lesions.
