{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:07:39Z","timestamp":1760238459437,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and ICT","award":["2018R1C1B5043725"],"award-info":[{"award-number":["2018R1C1B5043725"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Mucinous carcinoma of the retroperitoneal origin is extremely rare. The existence of mural nodules in association with retroperitoneal mucinous carcinoma is an even rarer condition and indicates a worse prognosis. We present a case of primary retroperitoneal mucinous carcinoma with carcinosarcomatous mural nodules in a 27-year-old woman. We found a histological spectrum of mucinous tumors encompassing a mucinous borderline tumor, microinvasive carcinoma, and overt carcinoma with an expansile invasive pattern. The mural nodules had two morphological components. The sarcomatous component consisted of diffusely proliferating pleomorphic spindle or polygonal cells, while the carcinomatous component exhibited infiltrative glands showing a complex and cribriform architecture as well as distorted and poorly formed small glands. The carcinomatous component, comprising approximately 20% of the entire tumor volume of the mural nodules, was randomly distributed within the sarcomatous component. In a few areas, the carcinomatous component transformed and merged into the sarcomatous component. Immunostaining revealed a mutually exclusive pattern of expression of cytokeratin and vimentin in the carcinomatous and sarcomatous components, respectively, supporting the presence of a dual tumor cell population and confirming the diagnosis of carcinosarcoma. In summary, our case exhibited a histological spectrum of mucinous tumors and a metaplastic transformation from the carcinomatous to sarcomatous component in mural nodules. The immunostaining results of a mutually exclusive expression pattern of epithelial and mesenchymal markers confirmed the histological evidence of a dual population. Although rare, the specific histological features and immunophenotype are helpful in establishing the diagnosis of carcinosarcomatous mural nodules. Since the pathogenetic mechanism and treatment strategies for primary retroperitoneal mucinous carcinoma remain unclear, pathologists have an essential role to play in correctly evaluating the presence of mural nodules and determining their nature, to be later utilized to predict patients\u2019 outcomes and provide appropriate treatment.<\/jats:p>","DOI":"10.3390\/diagnostics10080580","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T09:28:57Z","timestamp":1597138137000},"page":"580","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Primary Retroperitoneal Mucinous Carcinoma with Carcinosarcomatous Mural Nodules: A Case Report with Emphasis on Its Histological Features and Immunophenotype"],"prefix":"10.3390","volume":"10","author":[{"given":"Sujin","family":"Park","sequence":"first","affiliation":[{"name":"Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4730-221X","authenticated-orcid":false,"given":"Hyun-Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s40792-017-0394-z","article-title":"The long-term survival in primary retroperitoneal mucinous cystadenocarcinoma: A case report","volume":"3","author":"Tokai","year":"2017","journal-title":"Surg. Case Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/00004347-199401000-00008","article-title":"Mural nodules in common epithelial tumors of the ovary","volume":"13","author":"Baergen","year":"1994","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_3","first-page":"192","article-title":"Sarcoma-like mural nodule in a borderline mucinous tumor of the ovary: A rare entity","volume":"5","author":"Ghosh","year":"2014","journal-title":"J. Midlife Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1002\/1097-0142(197910)44:4<1332::AID-CNCR2820440426>3.0.CO;2-#","article-title":"Ovarian mucinous tumors with sarcoma-like mural nodules: A report of seven cases","volume":"44","author":"Prat","year":"1979","journal-title":"Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/PGP.0b013e31825f7c41","article-title":"Primary retroperitoneal mucinous cystadenoma with a sarcoma-like mural nodule: An immunohistochemical study with histogenetic considerations and literature review","volume":"32","author":"Demirel","year":"2013","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1097\/PAS.0b013e3181909018","article-title":"Primary retroperitoneal mucinous tumors: A clinicopathologic study of 18 cases","volume":"33","author":"Roma","year":"2009","journal-title":"Am. J. Surg. 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A report of two cases","volume":"3","author":"Russell","year":"1981","journal-title":"Diagn. Gynecol. Obs."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1111\/j.1525-1438.2007.01130.x","article-title":"Primary retroperitoneal mucinous cystadenocarcinoma associated with pregnancy","volume":"18","author":"Kashima","year":"2008","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1159\/000316268","article-title":"Primary retroperitoneal mucinous cystadenocarcinoma: A case report and review of the literature","volume":"70","author":"Dierickx","year":"2010","journal-title":"Gynecol. Obs. Investig."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1006\/gyno.1994.1295","article-title":"Primary mucinous cystoadenocarcinoma of the retroperitoneum: Two cases","volume":"55","author":"Tenti","year":"1994","journal-title":"Gynecol. 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Pathol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/10\/8\/580\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:59:02Z","timestamp":1760176742000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/10\/8\/580"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,11]]},"references-count":15,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,8]]}},"alternative-id":["diagnostics10080580"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics10080580","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2020,8,11]]}}}