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Appendiceal mucinous cystadenocarcinoma with mural nodules of anaplastic carcinoma and K-RAS mutation.

Mural nodules are well-established in ovarian and pancreatic mucinous cystic neoplasms, and they grossly and histopathologically differ from the mucinous component of the tumor, which could be benign or malignant. Malignant mural nodules may include anaplastic carcinoma, clear cell carcinoma, neuroendocrine carcinoma, giant cell carcinoma, carcinosarcoma, and sarcoma (1). Herein, we report the first case of an appendiceal mucinous cystadenocarcinoma with multiple mural nodules comprising anaplastic carcinoma with K-RAS gene mutation status in both components.