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IPMN of the Pancreas

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https://www.readbyqxmd.com/read/28215485/association-of-igg4-response-and-autoimmune-pancreatitis-with-intraductal-papillary-mucinous-neoplasms
#1
Amin A Hedayat, Mikhail Lisovsky, Arief A Suriawinata, Daniel S Longnecker
OBJECTIVES: Concurrent intraductal papillary-mucinous neoplasm (IPMN) and autoimmune pancreatitis (AIP) was observed in a patient (index case) at our institution. Cases of coincidental IPMN and type 1 AIP and concurrent ductal adenocarcinoma (PDAC) and AIP have been previously reported. In this study we evaluate the hypothesis that IPMN elicits an IgG4 response. METHODS: Twenty-one pancreases (including the index case) with IPMN resected at our institution were studied...
February 8, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28205123/isolated-pancreatic-uncinate-duct-ipmn
#2
Ajay V Maker, Vijay K Maker
The ventral pancreas originally forms as an evagination of the common bile duct at 32 days gestation and its duct, the uncinate duct, eventually rotates with the ventral anlage to join the dorsal pancreas and fuse with the main pancreatic duct. Thus, though often considered a "branch" duct of the pancreas, embryologically, the uncinate duct is the "main" pancreatic duct of the ventral pancreas. This concept is not fully addressed in the current definitions of intraductal papillary mucinous neoplasms of the pancreas (IPMN) where international consensus guidelines consider the main-duct IPMN as high risk for malignancy and most small branch-duct IPMN as low risk for malignancy...
February 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28197897/middle-segment-preserving-pancreatectomy-for-metachronous-intraductal-papillary-mucinous-neoplasm-after-pancreatoduodenectomy-a-case-report
#3
Mihoko Yamada, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida, Katsuhiko Uesaka
Total pancreatectomy has occasionally been performed to treat patients with multiple lesions (such as intraductal papillary mucinous neoplasm (IPMN)) or patients who have undergone repeated pancreatic resection. However, deficiencies of the exocrine and endocrine functions worsen patients' quality of life. Recently, there have been several case reports citing middle segment-preserving pancreatectomy (MSPP) as a safe procedure and beneficial with respect to preservation of the exocrine and endocrine functions...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28188442/patients-with-mccune-albright-syndrome-have-a-broad-spectrum-of-abnormalities-in-the-gastrointestinal-tract-and-pancreas
#4
Laura D Wood, Michaël Noë, Wenzel Hackeng, Lodewijk A A Brosens, Feriyl Bhaijee, Marija Debeljak, Jun Yu, Masaya Suenaga, Aatur D Singhi, Atif Zaheer, Alison Boyce, Cemre Robinson, James R Eshleman, Michael G Goggins, Ralph H Hruban, Michael T Collins, Anne Marie Lennon, Elizabeth A Montgomery
McCune-Albright Syndrome (MAS) is a rare sporadic syndrome caused by post-zygotic mutations in the GNAS oncogene, leading to constitutional mosaicism for these alterations. Somatic activating GNAS mutations also commonly occur in several gastrointestinal and pancreatic neoplasms, but the spectrum of abnormalities in these organs in patients with MAS has yet to be systematically described. We report comprehensive characterization of the upper gastrointestinal tract in seven patients with MAS and identify several different types of polyps, including gastric heterotopia/metaplasia (7/7), gastric hyperplastic polyps (5/7), fundic gland polyps (2/7), and a hamartomatous polyp (1/7)...
February 10, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28154275/pancreatic-fistula-extending-into-the-thigh-caused-by-the-rupture-of-an-intraductal-papillary-mucinous-adenoma-of-the-pancreas
#5
Yuki Shimizu, Hiroshi Imaizumi, Hiroshi Yamauchi, Kosuke Okuwaki, Shiro Miyazawa, Tomohisa Iwai, Miyoko Takezawa, Mitsuhiro Kida, Erina Suzuki, Makoto Saegusa, Wasaburo Koizumi
We herein report the first case of a pancreatic fistula extending into the thigh caused by the rupture of an intraductal papillary mucinous neoplasm (IPMN) of the pancreas. An 80-year-old man was suspected to have necrotizing fasciitis because of right femoral pain. Computed tomography showed fluid retention from the pancreatic head to the right iliopsoas muscle and an IPMN at the pancreatic head. The findings of endoscopic retrograde pancreatography led to the suspicion of a minor leak and a pancreatic stent was placed...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28153575/intraductal-papillary-mucinous-neoplasms-of-the-pancreas-correlation-of-helical-computed-tomography-ct-features-with-pathologic-findings
#6
Wanbo Xu, Xiaojin Liu, Jiawen Zhang, Li Yang
RATIONALE AND OBJECTIVES: Intraductal papillary mucinous neoplasms (IPMNs) are precancerous lesions of the pancreas. Computed tomography (CT) has been recommended to screen the malignant potential of IPMNs. However, data evaluating the use of CT to differentiate categories of IPMN based on disease progression are limited. This study aimed to explore the correlation between CT characteristics and pathology in IPMN associated with invasive carcinoma. MATERIALS AND METHODS: A total of 31 patients with intraductal papillary mucinous carcinoma (IPMC) treated at one local regional hospital in Shanghai, China, were enrolled in this study...
January 30, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28144718/diagnostic-performance-and-imaging-features-for-predicting-the-malignant-potential-of-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-a-comparison-of-eus-contrast-enhanced-ct-and-mri
#7
Seo-Youn Choi, Jung Hoon Kim, Mi Hye Yu, Hyo Won Eun, Hae Kyung Lee, Joon Koo Han
PURPOSE: To compare diagnostic performance for prediction of malignant potential in IPMNs between EUS, contrast-enhanced CT and MRI. MATERIALS AND METHODS: 76 patients with IPMN (benign = 37, malignant = 39) underwent EUS, contrast-enhanced CT, and MRI. EUS was analyzed based on formal reports and contrast-enhanced CT and MRI were retrospectively analyzed by two radiologists according to the consensus guidelines 2012. Diagnostic performance and imaging features of malignant IPMNs were analyzed using ROC analysis and multivariate analyses...
January 31, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28133317/-pancreatic-adenosquamous-carcinoma-that-developed-after-resection-of-ipma-in-the-pancreatic-tail
#8
Akinao Kaneta, Takao Tsuchiya, Takahiro Saito, Satoshi Otani, Fujio Ito, Junichi Miura
Pancreatic adenosquamous carcinoma coexisting with intraductal papillary mucinous neoplasm(IPMN)is extremely rare. We report a rare case of pancreatic adenosquamous carcinoma that developed after resection of intraductal papillary mucinous adenoma(IPMA). A 67-year-old man was suspected of having a pancreatic cystic lesion. MRCP demonstrated a cystic lesion measuring 25mm in the pancreatic tail, which had an enhanced nodule. We therefore diagnosed branch duct type IPMN of the pancreas. Although pancreatic juice cytology did not indicate malignancy, we performed laparoscope-assisted distal pancreatectomy...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133201/-long-term-survival-in-response-to-multimodality-therapy-in-a-patient-with-invasive-pancreatic-cancer-with-cyst-formation
#9
Hironobu Makino, Hisashi Kametaka, Tadaomi Fukada, Kazuhiro Seike, Akio Hasegawa, Masaru Isozaki
The patient was a 61-year-old man. Computed tomography(CT)in April 2007 revealed a pancreatic cyst in the tail of the pancreas. Rapid enlargement was noted in November 2007, and the patient was referred to the surgery department. CT showed a cystic lesion containing a nodular shadow in the pancreatic tail. Tumor marker measurements yielded normal carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)levels, but the duke pancreatic monoclonal antigen type 2(DUPAN-2)level was elevated. A diagnosis of mucinous cystic neoplasm(MCN)of the pancreas was made in December 2007, and distal pancreatectomy and partial colectomy were performed...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133130/-a-resected-case-of-intraductal-pupillary-mucinous-neoplasm-of-the-pancreas-characterized-by-recurrence-in-the-remnant-pancreas-and-multiple-malignant-neoplasms-in-other-organs
#10
Ryo Yoshioka, Yoshito Tomimaru, Kozo Noguchi, Hirotsugu Nagase, Atsushi Hamabe, Masashi Hirota, Kazuteru Oshima, Tsukasa Tanida, Tomono Kawase, Shunji Morita, Hiroshi Imamura, Takashi Iwazawa, Kenzo Akagi, Shiro Adachi, Keizo Dono
A 74-year-old man underwent pancreaticoduodenectomy for intraductal pupillary mucinous neoplasm(IPMN)of the pancreatic head. Histopathological examination of the specimen revealed non-invasive intraductal papillary mucinous carcinoma( IPMC). Two years after surgery, recurrent IPMN developed in the remnant pancreas, and a liver tumor was identified in S8 of the liver. The patient underwent total pancreatectomy of the remnant pancreas and partial resection of S8. These tumors were histopathologically diagnosed as invasive IPMC and hepatocellular carcinoma, respectively...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28126546/management-of-undifferentiated-solitary-mucinous-cystic-lesion-of-the-pancreas-a-clinical-dilemma
#11
Alexandra M Roch, Katherine Bigelow, Christian M Schmidt, Rosalie A Carr, Andrea L Jester, Eugene P Ceppa, Michael G House, Nicholas J Zyromski, Attila Nakeeb, C Max Schmidt
BACKGROUND: Management of solitary mucinous cystic lesions of the pancreas (MCLs) relies on correct differentiation between branch-duct intraductal papillary mucinous neoplasm(BD-IPMN) and mucinous cystic neoplasm(MCN). Current international consensus guidelines recommend resection for MCN, whereas unifocal BD-IPMN may be followed in the absence of worrisome features/high-risk stigmata. We hypothesized that preoperative differentiation of solitary MCLs is suboptimal, and that all solitary MCLs should be treated similarly...
January 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28121262/detection-of-mutant-kras-and-tp53-dna-in-circulating-exosomes-from-healthy-individuals-and-patients-with-pancreatic-cancer
#12
Sujuan Yang, Sara P Y Che, Paul Kurywchak, Jena L Tavormina, Liv B Gansmo, Pedro Correa de Sampaio, Michael Tachezy, Maximilian Bockhorn, Florian Gebauer, Amanda R Haltom, Sonia A Melo, Valerie S LeBleu, Raghu Kalluri
Pancreatic cancer presents with a dismal mortality rate and is in urgent need of methods for early detection with potential for timely intervention. All living cells, including cancer cells, generate exosomes. We previously discovered double stranded genomic DNA in exosomes derived from the circulation of pancreatic cancer patients, which enabled the detection of prevalent mutations associated with the disease. Here, we report a proof-of-concept study that demonstrates the potential clinical utility of circulating exosomal DNA for identification of KRAS(G)(12)(D) and TP53(R)(273)(H) mutations in patients with pancreas-associated pathologies, including pancreatic ductal adenocarcinoma (PDAC), chronic pancreatitis (CP) and intraductal papillary mucinous neoplasm (IPMN), and in healthy human subjects...
January 25, 2017: Cancer Biology & Therapy
https://www.readbyqxmd.com/read/28117220/pancreatic-cysts-diagnostic-accuracy-and-risk-of-inappropriate-resections
#13
N de Pretis, S Mukewar, A Aryal-Khanal, Y Bi, N Takahashi, S Chari
BACKGROUND: Pancreatic cystic neoplasms (PCN) frequently undergo surgery, given malignant potential. Pancreatic cyst surgery is associated with significant rates of morbidity and mortality. It is crucial to accurately characterize these lesions pre-operatively to avoid unnecessary surgery in patients with benign pancreatic cysts. AIM: We aimed to assess the correlation between pre-operative (pre-op) diagnosis based on imaging and clinical presentation, and post-operative (post-op) diagnosis based on histopathology in patients undergone pancreatic cyst surgery...
January 12, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28109714/biliary-tumors-with-pancreatic-counterparts
#14
Yasuni Nakanuma, Yoshiko Sudo
Some biliary diseases mimic pancreatic diseases pathologically as well as pathogenetically. Such diseases can be called "biliary diseases with pancreatic counterparts". Biliary intraepithelial neoplasm (BilIN), intraductal papillary neoplasm of bile ducts (IPNB), hepatobiliary mucinous cystic neoplasm (hMCN), and IgG4-inflammatory pseudotumor represent the biliary counterparts of pancreatic intraepithelial neoplasm (PanIN), intraductal papillary mucinous neoplasm of pancreas (IPMN), pancreatic MCN, and mass forming type 1 autoimmune pancreatitis (AIP), respectively...
December 20, 2016: Seminars in Diagnostic Pathology
https://www.readbyqxmd.com/read/28088598/are-the-current-guidelines-for-the-surgical-management-of-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-adequate-a-multi-institutional-study
#15
Gregory C Wilson, Shishir K Maithel, David Bentrem, Daniel E Abbott, Sharon Weber, Clifford Cho, Robert C G Martin, Charles R Scoggins, Hong Jin Kim, Nipun B Merchant, David A Kooby, Michael J Edwards, Syed A Ahmad
BACKGROUND: Controversy persists regarding the management of patients with intraductal papillary mucinous neoplasms (IPMN). International consensus guidelines stratify patients into high-risk, worrisome, and low risk categories. STUDY DESIGN: The medical records of 7 institutions were reviewed for patients who underwent surgical management of IPMN between 2000 and 2015. RESULTS: There were 324 patients included in the analysis; 60.4% of patients had main-duct/mixed type, and 39...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28079542/development-and-validation-of-a-multi-institutional-preoperative-nomogram-for-predicting-grade-of-dysplasia-in-intraductal-papillary-mucinous-neoplasms-ipmns-of-the-pancreas-a-report-from-the-pancreatic-surgery-consortium
#16
Marc A Attiyeh, Carlos Fernández-Del Castillo, Mohammad Al Efishat, Anne A Eaton, Mithat Gönen, Ruqayyah Batts, Ilaria Pergolini, Neda Rezaee, Keith D Lillemoe, Cristina R Ferrone, Mari Mino-Kenudson, Matthew J Weiss, John L Cameron, Ralph H Hruban, Michael I D'Angelica, Ronald P DeMatteo, T Peter Kingham, William R Jarnagin, Christopher L Wolfgang, Peter J Allen
OBJECTIVE: Previous nomogram models for patients undergoing resection of intraductal papillary mucinous neoplasms (IPMNs) have been relatively small single-institutional series. Our objective was to improve upon these studies by developing and independently validating a new model using a large multiinstitutional dataset. SUMMARY BACKGROUND DATA: IPMNs represent the most common radiographically identifiable precursor lesions of pancreatic cancer. They are a heterogenous group of neoplasms in which more accurate markers of high-grade dysplasia or early invasive carcinoma could help avoid unnecessary surgery in 1 case and support potentially curative intervention (resection) in another...
September 20, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/28000629/effectiveness-of-contrast-enhanced-endoscopic-ultrasound-for-detecting-mural-nodules-in-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-and-for-making-therapeutic-decisions
#17
Mitsuru Fujita, Takao Itoi, Nobuhito Ikeuchi, Atsushi Sofuni, Takayoshi Tsuchiya, Kentaro Ishii, Kentaro Kamada, Junko Umeda, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, Shuntaro Mukai, Fuminori Moriyasu
BACKGROUND AND OBJECTIVES: There have been few studies to date evaluating the effectiveness of contrast-enhanced endoscopic ultrasound (CE-EUS) for detecting mural nodules in patients with branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN) of the pancreas. We aim to evaluate the effectiveness of CE-EUS for detecting mural nodules in BD-IPMN. PATIENTS AND METHODS: Of the 427 BD-IPMN patients, 21 patients (4.9%) in whom the presence of mural nodules was suggested by CE computed tomography (CT) or magnetic resonance imaging (MRI), or in whom the presence of nodule-like lesions as shown by fundamental EUS, were examined by CE-EUS...
November 2016: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/27995180/endoscopic-ultrasound-guided-fine-needle-aspiration-plus-kras-and-gnas-mutation-in-malignant-intraductal-papillary-mucinous-neoplasm-of-the-pancreas
#18
Barbara Bournet, Alix Vignolle-Vidoni, David Grand, Céline Roques, Florence Breibach, Jérome Cros, Fabrice Muscari, Nicolas Carrère, Janick Selves, Pierre Cordelier, Louis Buscail
Background:KRAS and GNAS mutations are common in intraductal papillary mucinous neoplasia of the pancreas (IPMN). The aims of this study were to assess the role of pre-therapeutic cytopathology combined with KRAS and GNAS mutation assays within cystic fluid sampled by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) to predict malignancy of IPMN. Patients and methods: We prospectively included 37 IPMN patients with clinical and/or imaging predictors of malignancy (men: 24; mean age: 69.5 years)...
December 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27992432/a-gastric-glycoform-of-muc5ac-is-a-biomarker-of-mucinous-cysts-of-the-pancreas
#19
Jessica Sinha, Zheng Cao, Jianliang Dai, Huiyuan Tang, Katie Partyka, Galen Hostetter, Diane M Simeone, Ziding Feng, Peter J Allen, Randall E Brand, Brian B Haab
Molecular indicators to specify the risk posed by a pancreatic cyst would benefit patients. Previously we showed that most cancer-precursor cysts, termed mucinous cysts, produce abnormal glycoforms of the proteins MUC5AC and endorepellin. Here we sought to validate the glycoforms as a biomarker of mucinous cysts and to specify the oligosaccharide linkages that characterize MUC5AC. We hypothesized that mucinous cysts secrete MUC5AC displaying terminal N-acetylglucosamine (GlcNAc) in either alpha or beta linkage...
2016: PloS One
https://www.readbyqxmd.com/read/27979602/association-between-serum-span-1-and-lymph-node-metastasis-in-invasive-intraductal-papillary-mucinous-neoplasm-of-the-pancreas
#20
Kodai Yamanaka, Atsuhiro Masuda, Hirochika Toyama, Hideyuki Shiomi, Yoh Zen, Keitaro Sofue, Mamoru Takenaka, Takashi Kobayashi, Arata Sakai, Yosuke Yagi, Takashi Nakagawa, Masaru Yoshida, Yoshifumi Arisaka, Yoshihiro Okabe, Hiromu Kutsumi, Takumi Fukumoto, Yonson Ku, Takeshi Azuma
BACKGROUND AND AIM: Lymph node metastasis predicts poorer prognoses in patients with invasive intraductal papillary mucinous neoplasms of the pancreas (IPMNs). Factors associated with lymph node metastasis of invasive IPMN remain unclear. Therefore, this study aimed to define factors associated with lymph node metastasis of invasive IPMN. METHODS: Between June 2000 to August 2015, 156 consecutive patients with IPMN underwent surgical resection at Kobe University Hospital, and were enrolled in this study...
January 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
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