MUC5AC and neoplasm: For high-risk LAMN (e.g., perforation, mucin dissemination, M1b disease, or mucin extending beyond the right iliac fossa), the risk of progression is appreciably higher (approximately 6%), and a structured surveillance program is recommended: annual contrast-enhanced CT scans with tumor marker assessments for the first 5 years, followed by CT every 2 years thereafter, extending overall surveillance to 10 years (23, 39).