[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-341505-105":59,"doc-detail-341505-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","colloid-carcinoma-of-the-pancreas-a-rare-initial-presentation-of-lynch-syndrome","Colloid Carcinoma of the Pancreas - A Rare Initial Presentation of Lynch Syndrome","","Lynch syndrome confers increased risk beyond colorectal cancer, including pancreatic tumors and precursor lesions such as intraductal papillary mucinous neoplasms. A man in his early 20s presented with a retroperitoneal mass involving the pancreatic head. After pancreaticoduodenectomy with para-aortic lymphadenectomy, pathology confirmed colloid carcinoma (mucinous noncystic carcinoma). Immunohistochemistry and molecular testing established Lynch syndrome, highlighting diagnostic implications despite the rarity of this presentation.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/colloid-carcinoma-of-the-pancreas-a-rare-initial-presentation-of-lynch-syndrome/341505/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/colloid-carcinoma-of-the-pancreas-a-rare-initial-presentation-of-lynch-syndrome/341505.png","ImageObject",300,407,{"name":92,"@type":93},"Oliver","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What was the initial clinical presentation in this case?","Question",{"text":113,"@type":114},"A man in his early 20s presented with intermittent abdominal pain, and imaging revealed a large complex cystic retroperitoneal mass involving the pancreatic head.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the pancreatic diagnosis confirmed?",{"text":118,"@type":114},"He underwent pancreaticoduodenectomy with para-aortic lymphadenectomy, and pathology showed well-differentiated colloid carcinoma (mucinous noncystic carcinoma).",{"name":120,"@type":111,"acceptedAnswer":121},"How was Lynch syndrome established?",{"text":122,"@type":114},"Immunohistochemistry showed loss of nuclear MSH2 expression with probable loss of MSH6, and follow-up testing demonstrated MSI-High status consistent with Lynch syndrome.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},341505,1790089890,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":52},8796095461610,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","ACG CASE REPORTS JOURNAL   \nCASE REPORT | PANCREAS  \nColloid Carcinoma of the Pancreas: A Rare Initial Presentation of Lynch Syndrome  \nZoon Tariq, MD 1 , Joanna Riess, MD 1 , Lynt B. Johnson, MD 1 , and Mamoun Younes, MD 1  \n1 George Washington University School of Medicine and Health Sciences, Washington DC  \n\n| ABSTRACT\u003Cbr>Patients with Lynch syndrome, most commonly associated with colorectal cancer, have an increased risk of developing other tumors including pancreatic ductal adenocarcinoma and precursor lesions, such as intraductal papillary mucinous neoplasms. Here, we present a case of a man in his early 20s who presented with a retroperitoneal mass involving the head of the pancreas. Following a pancreaticoduodenectomy combined with para-aortic lymphadenectomy, apathologic diagnosis ofcolloid carcinoma, also known as mucinous noncystic carcinoma, of the pancreas was reported. Further testing established the diagnosis of Lynch syndrome. This case is unique because colloid carcinoma of the pancreas is rare and has never been reported as an initial presentation of Lynch syndrome.\u003Cbr>KEYWORDS: lynch syndrome; colloid carcinoma; pancreatic cancer; mismatch repair; genetic testing |\n| --- |\n| INTRODUCTION\u003Cbr>Lynch syndrome is the most common cause of hereditary colorectal cancer.1–6 Patients with this syndrome also have an increased risk of developing malignant tumors of other organs including uterus, stomach, liver, kidney, and skin usually before the age of 50 years. Testing of tumor samples for defects in DNA mismatch repair (MMR) genes MLH1, MSH2, MSH6, PMS2, and EPCAM by\u003Cbr>\u003Cbr>Figure 1 . Computed tomography scan of the abdomen pelvis. Note large complex cystic retroperitoneal mass (*; 10 .1 3 5.2 cm) with internal calcifications involving the head of the pancreas, extending superiorly to the caudate lobe of the liver. |\n| ACG Case Rep J 2024;11:e01415 . doi:10 . 14309/crj.0000000000001415. Published online: July 12, 2024 Correspondence: Mamoun Younes, MD ([myounes@mfa.gwu.edu](myounes@mfa.gwu.edu)) . |\n\nACG Case Reports [Journal / Volume 11 acgcasereports.com 1](Journal / Volume 11 acgcasereports.com 1)  \nTariq et al Colloid Carcinoma of the Pancreas  \nFigure 2 . A) Macroscopic (gross) appearance of the pancreatic mass showing a well-demarcated tan-yellow firm mass (*) attached to the adjacent duodenum. B) Further cross-sections reveal a tan-white mucinous cut surface with focal areas of necrosis.  \nimmunohistochemical staining, followed by molecular testing, aids in diagnosis of Lynch syndrome, so patients and their relatives can be screened and counseled, appropriately.  \nCASE REPORT  \nThe patient was a man in his early 20s, without any previous known medical history, who initially presented with intermittent episodes of abdominal pain. Computed tomography of the abdomen at that time demonstrated a 10.1 3 5.2 cm large complex cystic retroperitoneal mass involving the head of the pancreas, extending up to the level ofthecaudate lobe ofthe liver(Figure1), with mass effect on the main and left portal vein, inferior vena cava, and left renal vein. Findings were also notable for diffuse para-aortic and left iliac chain lymphadenopathy. Subsequent magnetic resonance cholangiopancreatography suggested the bulk of the mass to be extrapancreatic but in continuity with the  \nduodenal loop and extending up to the porta hepatis with some mass effect on the portal vein and common bile duct. An endoscopic ultrasound-guided fine needle aspiration showed acellular mucin and small fragments of acinar tissue and gastrointestinal epithelium.  \nOne month later, a computed tomography-guided biopsy of a retroperitoneal lymph node showed scant atypical glandular epithelium in a background of abundant thick mucin. Of note, carcinoembryonic antigen was 2.1 (0–2.5 mg/L) and CA19-9 was 22.7 (,37 U/mL) . At that time, the patient was mainly asymptomatic except for early satiety and an intentional 60 lb weight loss over the course of the previous","cbCaimz03MxGLb8K","https://ap.wps.com/l/cbCaimz03MxGLb8K","pdf",1177594,"English","# Abstract\n# Introduction\n# Case report","[{\"question\":\"What was the initial clinical presentation in this case?\",\"answer\":\"A man in his early 20s presented with intermittent abdominal pain, and imaging revealed a large complex cystic retroperitoneal mass involving the pancreatic head.\"},{\"question\":\"How was the pancreatic diagnosis confirmed?\",\"answer\":\"He underwent pancreaticoduodenectomy with para-aortic lymphadenectomy, and pathology showed well-differentiated colloid carcinoma (mucinous noncystic carcinoma).\"},{\"question\":\"How was Lynch syndrome established?\",\"answer\":\"Immunohistochemistry showed loss of nuclear MSH2 expression with probable loss of MSH6, and follow-up testing demonstrated MSI-High status consistent with Lynch syndrome.\"}]","Colloid Carcinoma of the Pancreas - A Rare Initial Presentation of Lynch Syndrome | PDF",1790042261]