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IPMN of the Pancreas

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https://www.readbyqxmd.com/read/28735806/revisions-of-international-consensus-fukuoka-guidelines-for-the-management-of-ipmn-of-the-pancreas
#1
REVIEW
Masao Tanaka, Carlos Fernández-Del Castillo, Terumi Kamisawa, Jin Young Jang, Philippe Levy, Takao Ohtsuka, Roberto Salvia, Yasuhiro Shimizu, Minoru Tada, Christopher L Wolfgang
The management of intraductal papillary mucinous neoplasm (IPMN) continues to evolve. In particular, the indications for resection of branch duct IPMN have changed from early resection to more deliberate observation as proposed by the international consensus guidelines of 2006 and 2012. Another guideline proposed by the American Gastroenterological Association in 2015 restricted indications for surgery more stringently and recommended physicians to stop surveillance if no significant change had occurred in a pancreatic cyst after five years of surveillance, or if a patient underwent resection and a non-malignant IPMN was found...
July 13, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28724304/synchronous-intraductal-papillary-mucinous-neoplasm-and-a-pancreatic-neuroendocrine-tumor-more-than-a-coincidence
#2
Juliana M Costa, Sofia Carvalho, João B Soares
Although the association between intraductal papillary mucinous neoplasm of the pancreas (IPMN) and pancreatic neuroendocrine tumor (PNET) has been increasingly reported, whether this association is real or coincidence remains unclear. We report a case of synchronous IPMN and a PNET which were diagnosed preoperatively and discuss the tumorigenesis, clinicopathological features and management of these rare tumors based on the published literature. A 56-year-old male was incidentally diagnosed with a 14 mm branch duct IPMN and a 3...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28700444/multi-institutional-validation-study-of-pancreatic-cyst-fluid-protein-analysis-for-prediction-of-high-risk-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#3
Mohammad A Al Efishat, Marc F Attiyeh, Anne A Eaton, Mithat Gönen, Denise Prosser, Anna E Lokshin, Carlos Fernández-Del Castillo, Keith D Lillemoe, Cristina R Ferrone, Ilaria Pergolini, Mari Mino-Kenudson, Neda Rezaee, Marco Dal Molin, Matthew J Weiss, John L Cameron, Ralph H Hruban, Michael I D'Angelica, T Peter Kingham, Ronald P DeMatteo, William R Jarnagin, Christopher L Wolfgang, Peter J Allen
OBJECTIVE: Preliminary work by our group suggested that proteins within the pancreatic cyst fluid (CF) may discriminate degree of IPMN dysplasia. We sought to externally validate these markers and determine whether their inclusion in a preoperative clinical nomogram could increase diagnostic accuracy. SUMMARY BACKGROUND DATA: IPMN is the most common radiographically identifiable precursor to pancreatic cancer; however, the timing and frequency of its malignant progression are unknown, and there are currently no reliable preoperative tests that can determine the grade of dysplasia in IPMN...
July 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28697136/circulating-epithelial-cells-in-intraductal-papillary-mucinous-neoplasms-and-cystic-pancreatic-lesions
#4
Katherine E Poruk, Vicente Valero, Jin He, Nita Ahuja, John L Cameron, Matthew J Weiss, Anne Marie Lennon, Michael Goggins, Laura D Wood, Christopher L Wolfgang
OBJECTIVES: Circulating epithelial cells (CECs) are identified in the blood of patients with intraductal papillary mucinous neoplasms (IPMNs) despite the absence of malignancy. We assessed the blood of patients undergoing resection for IPMN or other benign pancreatic lesions for CECs. METHODS: Peripheral blood was collected from 26 patients prior to pancreatic resection and filtered by the ISET (Isolation by Size of Epithelial Tumor Cells) method. Circulating epithelial cells were identified with antibodies to cytokeratin and Pdx1 (pancreas and duodenal homeobox protein 1), a pancreas marker...
August 2017: Pancreas
https://www.readbyqxmd.com/read/28697135/validation-of-the-2012-fukuoka-consensus-guideline-for-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-from-a-single-institution-experience
#5
Songfeng Yu, Naoki Takasu, Toshihiro Watanabe, Tsuyoshi Fukumoto, Shinji Okazaki, Koji Tezuka, Shuichiro Sugawara, Ichiro Hirai, Wataru Kimura
OBJECTIVES: The 2012 Fukuoka consensus guideline has stratified the risks of malignant intraductal papillary mucinous neoplasm (IPMN) of the pancreas into "high-risk stigmata" (HRS) and "worrisome feature" (WF). This study aimed to evaluate its clinical validity based on a single institution experience. METHODS: Eighty-nine patients who underwent surgical resection with pathological diagnosis of IPMN were retrospectively studied. RESULTS: High-risk stigmata was significantly correlated with the prevalence of malignant IPMN as compared with WF...
August 2017: Pancreas
https://www.readbyqxmd.com/read/28695820/research-advances-in-clinical-and-imaging-characteristics-of-intraductal-papillary-mucinous-neoplasm-of-the-bile-duct
#6
(no author information available yet)
Understanding on the intraductal papillary mucinous neoplasm of the pancreas (IPMN-P) has dramatically improved in the past three decades. A new disease named intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) reported in recent years shares several similar clinical features with IPMN-P. The clinical manifestations and imaging characteristics of IPMN-B have been gradually recognized. This review summarizes some of the typical cases reported since 2000 and find that clinical manifestations of IPMN-B include epigastric discomfort,biliary colic,jaundice,intermittent fever,sometimes without any symptoms; imaging triads for IPMN-B are mucobilia,dilated bile duct,and bile duct mural nodule...
June 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28687431/resectable-invasive-ipmn-versus-sporadic-pancreatic-adenocarcinoma-of-the-head-of-the-pancreas-should-these-two-different-diseases-receive-the-same-treatment-a-matched-comparison-study-of-the-french-surgical-association-afc
#7
P Duconseil, J Périnel, A Autret, M Adham, A Sauvanet, L Chiche, J-Y Mabrut, J-J Tuech, C Mariette, N Régenet, J-M Fabre, P Bachellier, J-R Delpéro, F Paye, O Turrini
PURPOSE: To compare survival and impact of adjuvant chemotherapy in patients who underwent pancreaticoduodenectomy (PD) for invasive intraductal papillary mucinous neoplasm (IIPMN) and sporadic pancreatic ductal adenocarcinoma (PDAC). METHODS: From 2005 to 2012, 240 patients underwent pancreatectomy for IIPMN and 1327 for PDAC. Exclusion criteria included neoadjuvant treatment, pancreatic resection other than PD, vascular resection, carcinoma in situ, or <11 examined lymph nodes...
June 29, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28682431/uptodate-in-the-assessment-and-management-of-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#8
D Pagliari, A Saviano, M L Serricchio, A A Dal Lago, M G Brizi, F Lanza, R Manfredi, A Gasbarrini, F Attili
Intraductal Papillary Mucinous Neoplasms (IPMNs) are the most common cystic tumors of the pancreas and are considered premalignant lesions. IPMNs are characterized by the papillary growth of the ductal epithelium with rich mucin production, which is responsible for cystic segmental or diffuse dilatation of the main pancreatic duct (MPD) and/or its branches. According to the different involvement of pancreatic duct system, IPMNs are divided into main duct type (MD-IPMN), branch duct type (BD-IPMN), and mixed type (MT-IPMN)...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28634319/common-hepatic-artery-quadrifurcation-associated-with-right-hepatic-artery-from-superior-mesenteric-artery-during-laparoscopic-total-splenopancreasectomy
#9
Francesco Caruso, Giorgio Alessandri, Francesca Ciccarese, Giovanni Cesana, Matteo Uccelli, Giorgio Castello, Roberta Villa, Stefano Olmi
Hepatobiliopancreatic surgery is challenging becouse of the complexity of resections and reconstructions and variability of vascular anatomy. The arterial vascularization of the liver is susteined by the common hepatic artery (CHA) that originates from the celiac trunk (CT). The CHA bifurcates into the gastroduodenal artery (GDA) and proper hepatic artery (PHA) 0.5-1 cm medial to the common bile duct (CBD), and the PHA bifurcates into a right and a left branch at hepatic hilum. The most frequent variants are the right hepatic artery (RHA) from the superior mesenteric artery (SMA), the left hepatic artery (LHA) from the left gastric artery (LGA) or a combination of these two variants...
June 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28588880/estimation-of-the-prevalence-of-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-in-the-french-population-through-patients-waiting-for-liver-transplantation
#10
Lucie Laurent, Marie-Pierre Vullierme, Vinciane Rebours, Frédérique Maire, Olivia Hentic, Claire Francoz, François Durand, Philippe Ruszniewski, Philippe Lévy
BACKGROUND AND AIMS: Some studies have explored the prevalence of pancreatic cystic lesions (PCLs). Only one study based on magnetic resonance imaging (MRI) report examination focused specifically on intraductal papillary mucinous neoplasm (IPMN) in a European general population. The aim of this study was to evaluate the prevalence of IPMN in a population of patients who had MRI for a non-pancreatic disease. METHODS: We conducted a retrospective, single-center study...
June 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28573215/molecular-histologic-and-radiologic-findings-of-high-grade-invasive-adenocarcinoma-arising-in-oncocytic-subtype-of-intraductal-papillary-mucinous-neoplasm-a-case-report-and-review-of-literature
#11
Jared Shows, Christan Bartsch, Heather Carmichael, Irfan Qureshi, Barish Edil, Hubert Fenton
Background: We present a case of adenocarcinoma arising in the oncocytic subtype of intraductal papillary mucinous neoplasm (O-IPMN), with emphasis on the molecular findings in the adenocarcinoma component. Tissue microdissection and next-generation sequencing were performed using a 26 gene panel (AKT1, ALK, APC, BRAF, CDH1, CTNNB1, EGFR, ERBB2, FBXW7, FGFR2, FOXL2, GNAQ, GNAS, KIT, KRAS, MAP2K1, MET, MSH6, NRAS, PDGFRA, PIK3CA, PTEN, SMAD4, SRC, STK11, TP53) of cancer-related genes. Case Presentation: A 69-year-old Caucasian female presented with chest pain and was found to have findings consistent with acute pancreatitis...
2017: J Pancreat Cancer
https://www.readbyqxmd.com/read/28550497/clinicopathological-features-of-intraductal-papillary-neoplasms-of-the-bile-duct-a-comparison-with-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-with-reference-to-subtypes
#12
Yuki Fukumura, Yasuni Nakanuma, Yuko Kakuda, Masaru Takase, Takashi Yao
Intraductal papillary epithelial neoplasms of the pancreatobiliary system (intraductal papillary neoplasm of the bile duct (IPNB) and intraductal papillary mucinous neoplasm (IPMN)) seem to share many clinicopathological features; however, IPNB has not been fully characterized. In order to understand the clinicopathological/immunohistochemical features of IPNB better, we compared 52 cases of IPNB with 42 cases of IPMNs with mural nodules. The IPNB cases were divided into two groups according to their histological similarity and according to five key histological findings...
May 26, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28545033/microrna-expression-levels-as-diagnostic-biomarkers-for-intraductal-papillary-mucinous-neoplasm
#13
Lei Wang, Jianming Zheng, Chang Sun, Li Wang, Gang Jin, Lei Xin, Zhendong Jin, Dong Wang, Zhaoshen Li
Intraductal papillary mucinous neoplasms (IPMNs) are deadly exocrine mucinous tumors. Currently the molecular features and diagnostic markers of IPMNs are not well understood. In this study, we performed microRNA (miRNA) profiling assays to study the potential roles of miRNAs in IPMNs using 78 cases of IPMN patients and controls. When comparing the miRNA expression between IPMN patient samples and controls, we found that miR-210, miR-223, miR-221, miR-155 and miR-187 were differentially expressed in normal pancreas and IPMNs...
May 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28502930/branch-duct-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-involving-type-1-localized-autoimmune-pancreatitis-with-normal-serum-igg4-levels-successfully-diagnosed-by-endoscopic-ultrasound-guided-fine-needle-aspiration-and-treated-without-pancreatic
#14
Shinsuke Koshita, Yutaka Noda, Kei Ito, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yoshiharu Masaki, Hiroaki Kusunose, Toshitaka Sakai, Toji Murabayashi, Sho Hasegawa, Fumisato Kozakai, Jun Horaguchi, Takashi Sawai
We herein report a 68-year-old man with branch duct intraductal papillary mucinous neoplasms of the pancreas (BD-IPMNs) involving type 1 localized autoimmune pancreatitis (AIP) with normal serum IgG4 levels. Although he was referred to our medical center due to suspicion of pancreatic cancer concomitant with BD-IPMNs, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) revealed a mass suspected of being pancreatic cancer to be type 1 AIP. Steroid administration notably reduced the mass. Although the clinical diagnosis of pancreatic masses in patients with IPMN can be occasionally challenging, performing a pathological examination by EUS-FNA may prevent unnecessary pancreatic surgery in cases of possible AIP...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28495434/patterns-of-recurrence-and-long-term-outcomes-in-patients-who-underwent-pancreatectomy-for-intraductal-papillary-mucinous-neoplasms-with-high-grade-dysplasia-implications-for-surveillance-and-future-management-guidelines
#15
Aaron U Blackham, Matthew P Doepker, Barbara A Centeno, Gregory Springett, Jose M Pimiento, Mokenge Malafa, Pamela J Hodul
BACKGROUND: While intraductal papillary mucinous neoplasms (IPMNs) with high-grade dysplasia (HGD) are thought to represent non-invasive, high-risk lesions, its natural history following resection is unknown. METHODS: A retrospective review of HGD-IPMN patients (1999-2015) was performed. Recurrence patterns and clinical outcomes following pancreatectomy were analyzed and the indications for surgery were explored based on current guidelines. RESULTS: HGD was diagnosed in 100 of 314 patients (32%) following pancreatectomy for IPMN...
May 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28463669/pancreatic-cystic-lesions-diagnostic-management-and-indications-for-operation-part-i
#16
REVIEW
Ferdinand Bauer
We notice an increasing frequency in the detection and evaluation of pancreatic cystic lesions (PCLs) over the last three decades. They show awide spectrum of imaging and clinical features. The diagnosis and discrimination of these lesions are very important because of the risk for concurrent or later development of malignancy. The main reason is the increased awareness of these lesions and the extensive use of cross-sectional imaging, an always improving technique (1). Commonly, PCLs are diagnosed incidentally during investigation for often unrelated and nonspecific abdominal complaints using state-of-the art abdominal imaging (CT, MRT)...
March 2017: Chirurgia
https://www.readbyqxmd.com/read/28446039/intraductal-papillary-mucinous-neoplasm-of-the-pancreas-epidemiology-risk-factors-diagnosis-and-management
#17
Linus Aronsson, Roland Andersson, Daniel Ansari
Intraductal papillary mucinous neoplasm (IPMN) is one of the most common cystic neoplasms of the pancreas. It is a heterogeneous disease and can be divided into ductal types and morphological subtypes. The incidence of IPMN is increasing, likely due to the widespread use of cross-sectional imaging and a growing elderly population. IPMN poses an increasing demand on the health care system. Current guidelines provide indications for surgery and recommendations for surveillance, but management of IPMN is still challenging in routine clinical practice...
August 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28444494/imaging-of-pancreatic-cystic-lesions-with-confocal-laser-endomicroscopy-an-ex-vivo-pilot-study
#18
Abdurrahman Kadayifci, Mustafa Atar, Michelle Yang, Carlos Fernandez-Del Castillo, Mari Mino-Kenudson, William R Brugge
BACKGROUND: The differential diagnosis of pancreatic cystic lesions (PCLs) is an increasingly common clinical challenge. Confocal laser endomicroscopy (CLE) may differentiate PCLs by imaging of the cyst wall. However, clinical experience is still limited, and better image definition and characterization of the cyst wall in a spectrum of cysts are needed. This experimental study aimed to expose detailed imaging characteristics of PCLs by CLE. METHODS: Patients who underwent surgery of a PCL were enrolled...
April 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28416122/patients-with-a-resected-pancreatic-mucinous-cystic-neoplasm-have-a-better-prognosis-than-patients-with-an-intraductal-papillary-mucinous-neoplasm-a-large-single-institution-series
#19
James F Griffin, Andrew J Page, Georges J Samaha, Adrienne Christopher, Feriyl Bhaijee, Maryam K Pezhouh, Niek A Peters, Ralph H Hruban, Jin He, Martin A Makary, Anne Marie Lennon, John L Cameron, Christopher L Wolfgang, Matthew J Weiss
BACKGROUND/OBJECTIVES: Mucinous cystic neoplasms (MCNs) are rare pancreas tumors distinguished from intraductal papillary mucinous neoplasms (IPMNs) by the presence of ovarian-type stroma. Historical outcomes for MCNs vary due to previously ambiguous diagnostic criteria resulting in confusion with IPMNs. This study seeks to characterize and clarify the clinical features and long-term outcomes of MCNs versus IPMNs in the largest single-institution series of pathology-confirmed MCNs to date...
April 11, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28412205/slc2a1-glut1-expression-in-mural-nodules-of-intraductal-papillary-mucinous-neoplasm-of-the-pancreas
#20
Yasunori Oda, Shinichi Aishima, Koji Shindo, Minoru Fujino, Yusuke Mizuuchi, Masami Hattori, Tetsuyuki Miyazaki, Masao Tanaka, Yoshinao Oda
In intraductal papillary mucinous neoplasms (IPMNs), the presence of a mural nodule showing a papillary or nodular proliferation of tumor cells in the dilated pancreatic duct is an indication for resection of the IPMN. Solute carrier family 2, facilitated glucose transporter member 1, known as Glucose transporter type 1 (SLC2A1/GLUT1) mediates cellular glucose uptake in many carcinomas and is correlated with increased 18F-fluorodeoxyglucose ((18)F-FDG) uptake. We examined SLC2A1/GLUT1 expression in the mural nodules of 180 IPMN specimens to distinguish malignant/benign tumors...
April 12, 2017: Human Pathology
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