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IPMN of the Pancreas

Giulio Innamorati, Thomas M Wilkie, Havish S Kantheti, Maria Teresa Valenti, Luca Dalle Carbonare, Luca Giacomello, Marco Parenti, Davide Melisi, Claudio Bassi
BACKGROUND: Mutations activating the α subunit of heterotrimeric Gs protein are associated with a number of highly specific pathological molecular phenotypes. One of the best characterized is the McCune Albright syndrome. The disease presents with an increased incidence of neoplasias in specific tissues. MAIN BODY: A similar repertoire of neoplasms can develop whether mutations occur spontaneously in somatic tissues during fetal development or after birth. Glands are the most "permissive" tissues, recently found to include the entire gastrointestinal tract...
March 15, 2018: BMC Cancer
Naoto Imagawa, Mitsuharu Fukasawa, Ei Takahashi, Hiroko Shindo, Shinichi Takano, Tadashi Sato, Hiromitsu Kawaida, Hideki Fujii, Tadao Nakazawa, Nobuyuki Enomoto
A 77-year-old woman with mild dilatation (4mm) of the main pancreatic duct was referred to our hospital. Contrast-enhanced computed tomography revealed segmental dilatation of the main pancreatic duct in the pancreatic tail, but no mass was noted in the pancreas. Endoscopic ultrasonography showed low papillary lesions in the dilated pancreatic duct. Cytological analysis of the pancreatic juice revealed adenocarcinoma. Distal pancreatectomy was performed for a diagnosis of main duct-intraductal papillary mucinous cancer (MD-IPMC) of the pancreatic tail...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Nandhini Srinivasan, Jin-Yao Teo, Yung-Ka Chin, Tiffany Hennedige, Damien M Tan, Albert S Low, Choon Hua Thng, Brian K P Goh
BACKGROUND: This systematic review was performed to assess the clinical utility of the Sendai Consensus Guidelines (SCG) and Fukuoka Consensus Guidelines (FCG) for intraductal papillary mucinous neoplasm (IPMN). METHODS: A computerized search of PubMed was performed to identify all the studies which evaluated the SCG and FCG in surgically resected, histologically confirmed IPMNs. RESULTS: Ten studies evaluating the FCG, 8 evaluating the SCG and 4 evaluating both guidelines were included...
February 24, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Hiroaki Seki, Nobutaka Yasui, Akihiko Shimada, Hidetoshi Matsumoto
We herein report a 75-year-old woman who presented with an intraductal papillary mucinous carcinoma(IPMC)who was treated with surgical resection 4 years after the initial diagnosis was made. She previously underwent a high anterior resection of the rectum for rectal cancer at 71 years of age. Preoperative CT revealed a multilocular cystic mass measuring 6 cm in size in the body of the pancreas, which was considered benign. We followed up the intraductal papillary mucinous neoplasm(IPMN) by using annual CT imaging for 4 years...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Takahiro Einama, Hirofumi Kamachi, Toshihiro Sakata, Kengo Shibata, Kazuki Wakizaka, Ko Sugiyama, Kazuaki Shibuya, Shingo Shimada, Kenji Wakayama, Tatsuya Orimo, Hideki Yokoo, Toshiya Kamiyama, Tomoko Mitsuhashi, Akinobu Taketomi
Intraductal papillary mucinous neoplasms (IPMNs) are characterized by the papillary proliferation of atypical mucinous epithelial cells in the pancreatic ductal system. There are two recurrence patterns following resection of IPMNs: Metachronous multifocal occurrence of IPMNs, and distinct pancreatic ductal adenocarcinoma (PDAC) in the remnant pancreas. Several recent studies investigated the development of distinct PDAC during follow-up evaluation of IPMNs and the incidence rate ranged from 4.5 to 8%. Thus, IMPNs may be a good predictor for the early detection of PDAC during observation or after the resection of IPMNs...
March 2018: Molecular and Clinical Oncology
Giovanni Marchegiani, Stefano Andrianello, Alex Borin, Chiara Dal Borgo, Giampaolo Perri, Tommaso Pollini, Giorgia Romanò, Mirko D'Onofrio, Armando Gabbrielli, Aldo Scarpa, Giuseppe Malleo, Claudio Bassi, Roberto Salvia
BACKGROUND: Mural nodules (MNs) have a predominant role in the 2016 revision of the international guidelines on intraductal papillary mucinous neoplasms (IPMN) of the pancreas. The aim of this study was to evaluate MNs as predictors of invasive cancer (iCa) or high-grade dysplasia (HGD) in IPMNs and to investigate the role of MN size in risk prediction. METHODS: A PRISMA-compliant systematic review of the literature and meta-analysis on selected studies were conducted...
February 14, 2018: Surgery
Stefan Fritz, Regina Küper-Steffen, Katharina Feilhauer, Christoph M Sommer, Götz M Richter, René Hennig, Jörg Köninger
RATIONALE: Intraductal papillary mucinous neoplasms of the pancreas (IPMNs) are benign cystic tumors with a relevant risk of malignant transformation over time. Currently, follow-up after surgical resection of benign IPMNs remains controversial. PATIENT CONCERNS: This is a case report of a 68-year-old male who underwent pancreatic head resection for a multicystic side-branch IPMN with low-grade epithelial dysplasia in March 2009 at the Katharinenhospital Stuttgart, Germany...
February 2018: Medicine (Baltimore)
Hideki Mori, Keiji Hanada, Tomoyuki Minami, Shigeki Yano, Motomitsu Fukuhara, Hirotsugu Maruyama, Akinori Shimizu, Naomichi Hirano, Fumiaki Hino, Hironobu Amano, Shuji Yonehara
A previously healthy 52-year-old man was referred to our hospital for further evaluation of main pancreatic duct dilatation. The preoperative work-up was consistent with intraductal papillary mucinous carcinoma (IPMC) derived from a mixed type intraductal papillary mucinous neoplasm (IPMN), because multilocular cysts with enhancing thickened pancreatic head walls and dilated pancreatic ducts lined with dysplastic mucinous epithelium, with papillary proliferation from the pancreatic body to the tail, were observed; in addition, the pancreatic juice cytology was class V, which is suggestive of adenocarcinoma...
February 13, 2018: Clinical Journal of Gastroenterology
Annabelle L Fonseca, Kimberly Kirkwood, Michael P Kim, Anirban Maitra, Eugene J Koay
The incidence of intraductal papillary mucinous neoplasms (IPMNs) has been increasing over the past decade, mainly owing to increased awareness and the increased use of cross-sectional imaging. The Sendai and Fukuoka consensus guidelines provide us with clinical management guidelines and algorithms; however, the clinical management of IPMNs continues to be challenging. Our incomplete understanding of the natural history of the disease, and the events and pathways that permit progression to adenocarcinoma, result in difficulties predicting which tumors are high risk and will progress to invasive disease...
March 2018: Pancreas
Chiara Dal Borgo, Giampaolo Perri, Alex Borin, Giovanni Marchegiani, Roberto Salvia, Claudio Bassi
BACKGROUND: Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas comprise a heterogeneous group of intraductal mucin-producing neoplasms representing a typical adenoma-to-carcinoma sequence. The involvement of the main pancreatic duct (MPD) is a feature of paramount importance, directly related to a more aggressive biology and a higher malignancy rate. METHOD: We review and discuss the clinical management of IPMNs with a MPD involvement, recalling the different consensus guidelines and addressing recent controversies in literature, presenting the current clinical practice in Verona Pancreas Institute...
February 8, 2018: Digestive Surgery
Ji Y Park, Jae Hoon Lee, Ki-Byung Song, Dae Wook Hwang, Kyu-Rae Kim, Song Cheol Kim, Seung-Mo Hong
Microcystic, elongated, and fragmented (MELF) glandular features are associated with epithelial-mesenchymal transition, invasion, and progression in endometrioid adenocarcinoma of the uterus. Similar histological features are also observed at the periphery of pancreatic intraductal papillary mucinous neoplasms (IPMNs). However, the clinicopathological significance of MELF-like features-particularly whether they represent regenerative or truly neoplastic conditions-in IPMNs remains unclear. We assessed a total of 152 surgically resected IPMNs...
February 1, 2018: Human Pathology
Yukiyasu Okamura, Shusei Sano, Teiichi Sugiura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Keiko Sasaki, Katsuhiko Uesaka
OBJECTIVES: The aim of the present study was to validate the use of the 2012 International Consensus Guidelines for intraductal papillary mucinous neoplasm (IPMN) (Fukuoka criteria) in patients without findings of obstructive jaundice and/or an enhanced solid component. METHODS: This retrospective study included patients who underwent pancreatectomy for IPMN between October 2002 and September 2016. The sensitivity, specificity, and positive and negative predictive values for malignancy were calculated for each feature of high-risk stigmata...
March 2018: Pancreas
Tiana J Raphel, Davis T Weaver, Lincoln L Berland, Brian R Herts, Alec J Megibow, Amy B Knudsen, Pari V Pandharipande
Purpose To determine the effects of patient age and comorbidity level on life expectancy (LE) benefits associated with imaging follow-up of Bosniak IIF renal cysts and pancreatic side-branch (SB) intraductal papillary mucinous neoplasms (IPMNs). Materials and Methods A decision-analytic Markov model to evaluate LE benefits was developed. Hypothetical cohorts with varied age (60-80 years) and comorbidities (none, mild, moderate, or severe) were evaluated. For each finding, LE projections from two strategies were compared: imaging follow-up and no imaging follow-up...
February 5, 2018: Radiology
Takashi Noma, Hajime Hirose, Yoshito Ide, Hiroki Imamura, Yuriko Yagi, Yukako Mokutani, Yasuji Hashimoto, Kenichi Nagai, Jin Matsuyama, Masaru Kubota, Yukio Fukushima, Shigeyuki Tamura, Yo Sasaki
A 70's woman with a history of abdominal surgery for gastric cancer visited our hospital for the evaluation of bleeding during defecation.We diagnosed her with advanced rectal cancer and performed laparoscopic low anterior resection.As postoperative pathological staging was pT3N2M0, pStage III b, we included CapeOx therapy as adjuvant chemotherapy.One year and 4 months after the surgery, lung and liver metastases were revealed by CT and PET-CT scans.At the same time, dilatation of the main pancreatic duct(intraductal papillary mucinous neoplasm: IPMN)was detected...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Ken Liu, Vikram Joshi, Louise van Camp, Qi-Wei Yang, Judith E Baars, Simone I Strasser, Geoffrey W McCaughan, Avik Majumdar, Payal Saxena, Arthur J Kaffes
AIM: To determine the prevalence, characteristics and clinical course of pancreatic cystic neoplasms (PCNs) in liver transplantation (LT) recipients. METHODS: We retrospectively studied consecutive patients who underwent LT between January 1998 to April 2016. Clinical and laboratory data were obtained from patient medical records. Imaging findings on computed tomography and magnetic resonance cholangiopancreatography were reviewed by two radiologists. RESULTS: During the study period, 872 patients underwent cadaveric LT...
December 28, 2017: World Journal of Gastroenterology: WJG
Vicente Morales-Oyarvide, Zhi Ven Fong, Carlos Fernández-Del Castillo, Andrew L Warshaw
Intraductal papillary mucinous neoplasms (IPMN) are cystic neoplasms with the potential for progression to pancreatic cancer. Recognized by the global medical community just over two decades ago, IPMN have gained great epidemiological and clinical relevance thanks to the widespread use of cross-sectional abdominal imaging, which has led to a surge in the number of incidental pancreatic cysts being diagnosed. As our understanding of this disease has improved, we now know that some IPMN have a very elevated risk of cancer and require surgical resection, while others are low-risk lesions and can be followed...
December 2017: Visceral Medicine
Laura Uribarri-Gonzalez, Margaret G Keane, Stephen P Pereira, Julio Iglesias-García, J Enrique Dominguez-Muñoz, Jose Lariño-Noia
BACKGROUND/OBJECTIVES: To evaluate the agreement between the imaging modalities MRI-MRCP and EUS in cystic lesions of the pancreas which were thought to be a BD-IPMN. METHODS: Multicenter retrospective study included all patients between 2010 and 2015 with a suspected BD-IPMN who underwent an EUS and MRI-MRCP within 6 months or less of each other. Location, number, size, worrisome features and high-risk stigmata were evaluated. Interobserver agreement was evaluated by Kappa score...
January 4, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
(no author information available yet)
Objective: To analyze the current status of diagnosis and treatment of pancreatic cystic neoplasm(PCN)in China. Methods: Clinical data of 2 251 PCN patients who underwent surgical resection from January 2006 to December 2016 in 16 institutions was retrospectively analyzed.Excel database was created which covered 132 fields of 7 fields: general information of patients, imaging findings, preoperative blood biochemical indexes, tumor markers, surgical related data, postoperative complications and pathology. Results: Of the 2 251 patients, the male to female ratio was 1...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Ahmad Abu Turab Naqvi, Gulam Mustafa Hasan, Md Imtaiyaz Hassan
Pancreatic cancer (PC) is the seventh most common cause of cancer-related deaths worldwide that kills more than 300,000 people every year. Prognosis of PC is very poor with a five-year survival rate about 5%. The most common and highly observed type of PC is pancreatic ductal adenocarcinoma (PDAC). It is preceded by the progression of precursor lesions such as Pancreatic Intraepithelial Neoplasia (PanIN), Intraductal Papillary Neoplasm (IPMN) and Mucinous Cystic Neoplasm (MCN). PanIN is the most common among these premalignant lesions...
March 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
I L Eok Jo, Dae Hwan Kang, Cheol Woong Choi, Hyung Wook Kim, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu
Hemosuccus pancreaticus is an unusual gastrointestinal hemorrhage through the main pancreatic duct. We report a rare case of hemosuccus pancreaticus due to a simple mucinous cyst of the pancreas. A 52-year-old man who had been followed-up for a suspected branch duct intraductal papillary mucinous neoplasm (IPMN) visited the emergency room due to hematochezia. Endoscopy showed active bleeding from the ampulla. Computed tomography revealed hemorrhage in a 2.0-cm cystic mass in the pancreatic body. The patient was diagnosed with hemosuccus pancreaticus caused by bleeding into the main pancreatic duct from suspected IPMN...
December 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
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