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IPMN of the Pancreas

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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
#1
Gregory C Wilson, Shishir K Maithel, David Bentrem, Daniel E Abbott, Sharon Weber, Clifford Cho, Robert Cg 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 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 that underwent surgical management of IPMN between 2000-2015. RESULTS: 324 patients were included in the analysis. 60.4% of patients had main-duct / mixed type, and 39.7% had branch-duct IPMN...
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
#2
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
#3
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
#4
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
#5
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
#6
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...
December 10, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27920477/evolution-of-incidental-branch-duct-intraductal-papillary-mucinous-neoplasms-of-the-pancreas-a-study-with-magnetic-resonance-imaging-cholangiopancreatography
#7
Rossano Girometti, Riccardo Pravisani, Sergio Giuseppe Intini, Miriam Isola, Lorenzo Cereser, Andrea Risaliti, Chiara Zuiani
AIM: To investigate the type and timing of evolution of incidentally found branch-duct intraductal papillary mucinous neoplasms (bd-IPMN) of the pancreas addressed to magnetic resonance imaging cholangiopancreatography (MRCP) follow-up. METHODS: We retrospectively evaluated 72 patients who underwent, over the period 2006-2016, a total of 318 MRCPs (mean 4.4) to follow-up incidental, presumed bd-IPMN without signs of malignancy, found or confirmed at a baseline MRCP examination...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27882420/the-clinical-indications-for-limited-surgery-of-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#8
Kenjiro Kimura, Ryosuke Amano, Sadaaki Ymazoe, Go Ohira, Kohei Nishio, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: There are many reports about limited surgery for intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. However, there is no consensus on limited surgery for IPMNs. The primary objective of this study was to define the clinical indications for limited surgery for IPMNs. METHODS: The data of 98 patients who underwent curative resections for IPMN were retrospectively analyzed. IPMNs were classified into four different pathological grades: low-grade dysplasia (LGD), intermediate-grade dysplasia (IGD), high-grade dysplasia (HGD), and invasive carcinoma (Inv-IPMN)...
November 23, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27878841/intraductal-papillary-mucinous-neoplasms-of-the-pancreas-reporting-clinically-relevant-features
#9
REVIEW
Marco Del Chiaro, Caroline Verbeke
Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas can exhibit a wide spectrum of macroscopic and microscopic appearances. This not only causes occasional difficulties for the reporting pathologist in distinguishing these tumours from other lesions, but is also relevant clinically. As evidence accumulates, it becomes clear that multiple macroscopic and histological features of these neoplasms are relevant to the risk for malignant transformation and, consequently, of prime importance for clinical patient management...
November 22, 2016: Histopathology
https://www.readbyqxmd.com/read/27876450/intraductal-papillary-neoplasm-of-the-bile-duct-a-case-report
#10
Karen Peeters, Peter Delvaux, Frederik Huysentruyt
Intraductal papillary neoplasm of the bile duct (IPNB) is a rare variant of bile duct tumors, characterized by papillary growth within the bile duct lumen and is regarded as a biliary counterpart of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. IPNBs are mainly found in patients from Far Eastern areas, where hepatolithiasis and clonorchiasis are endemic. The Western experience, however, remains limited. In this article, we report a 56-year-old man, referred to our hospital because of deranged liver function tests...
November 23, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27865286/intraductal-papillary-mucinous-neoplasm-of-the-pancreas
#11
REVIEW
Zhi Ven Fong, Carlos Fernández-Del Castillo
The incidence of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas has been rising in the past 2 decades, driven mainly by the widespread use of cross-sectional imaging. IPMNs are intraductal mucin-producing neoplasms that involve the main pancreatic duct or its side branches and lack the ovarian stroma typically seen in mucinous cystic neoplasms. The International Association of Pancreatology released consensus guidelines in 2006 and 2012 providing clinical algorithms based on IPMN features and risk of malignancy...
December 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27864998/rnf43-mutation-frequently-occurs-with-gnas-mutation-and-mucin-hypersecretion-in-intraductal-papillary-neoplasms-of-the-bile-duct
#12
Jia-Huei Tsai, Jau-Yu Liau, Chang-Tsu Yuan, Mei-Ling Cheng, Ray-Hwang Yuan, Yung-Ming Jeng
RNF43 is a tumor suppressor gene that is frequently mutated in intraductal papillary mucinous neoplasms of the pancreas (IPMN). RNF43 suppresses the Wnt/β-catenin signaling pathway. We conducted mutation analysis of RNF43 in intraductal papillary neoplasms of the bile duct (IPNBs) and identified RNF43 mutation in 6 (12%) out of 50 IPNBs. RNF43 mutation was more frequent in the intestinal subtype of IPNB (17%) than in the gastric/pancreatobiliary subtype (5%). There were a strong association of RNF43 mutation with GNAS (P = ...
November 16, 2016: Histopathology
https://www.readbyqxmd.com/read/27825416/clinicopathological-features-of-intraductal-pancreatic-neuroendocrine-tumors
#13
Xiao-Yan Chang, Cong-Wei Jia, Yun-Xiao Meng, Jie Chen
Objective To evaluate the clinical and pathologic characteristics of intraductal pancreatic neuroendocrine tumors (PanNETs). Methods Four cases of intraductal PanNETs were studied by light microscopy and immunohistochemistry with the analysis of morphologic features and review of relevant literatures. Results Two female patients and two male patients aged 41- 58 years were enrolled in this study. The chief complaint was abdominal pain in two patients,vomiting in one patient,and jaundice in the last patient...
October 10, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/27824244/a-large-multicenter-study-of-recurrence-after-surgical-resection-of-branch-duct-intraductal-papillary-mucinous-neoplasm-of-the-pancreas
#14
Linda Yan, Ali A Siddiqui, Sobia Laique, Monica Saumoy, Michel Kahaleh, Joseph Yoo, Ankush Kalra, Arun Mathew, Jessica Sterling, Rema Rao, Michael Lieberman, Natalie Cosgrove
BACKGROUND: Surgery for pancreatic branch-duct intraductal papillary mucinous neoplasm (BDIPMN) is indicated for therapy of symptomatic patients and to prevent development of invasive cancer. There is currently no consensus on management of BD-IPMN patients after surgical resection. The aim of this retrospective multicenter study was to determine the recurrence and long-term survival after surgical resection of BD-IPMN and to determine the predictive factors of recurrence. METHODS: All patients who underwent surgery for BD-IPMN from 2005 to 2011 at 2 centers were identified...
November 8, 2016: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27822633/survival-analysis-and-risk-for-progression-of-intraductal-papillary-mucinous-neoplasia-of-the-pancreas-ipmn-under-surveillance-a-single-institution-experience
#15
Marco Del Chiaro, Zeeshan Ateeb, Marcus Reuterwall Hansson, Elena Rangelova, Ralf Segersvärd, Nikolaos Kartalis, Christoph Ansorge, Matthias J Löhr, Urban Arnelo, Caroline Verbeke
PURPOSE: While surveillance of the majority of patients with IPMN is considered best practice, consensus regarding the duration of follow-up is lacking. This study assessed the survival rate and risk for progression of IPMN under surveillance. METHODS: All patients diagnosed with and surveyed for IPMN between January 2008 and December 2013 were identified and assigned to two groups: patients without indication for surgery (Group 1), and patients whose IPMN required surgery but were inoperable for general reasons (Group 2)...
November 7, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27816353/predisposing-factors-for-pancreatic-adenocarcinoma-what-is-the-role-of-imaging
#16
M-P Vullierme, M Lagadec
Early detection of pancreatic adenocarcinoma is the goal of imaging, enabling curative surgery. The identification of high-grade dysplastic precursor lesions is even more beneficial. Two forms are now better known: pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN). To detect these lesions with imaging, we need to know the patterns associated with them. A screening program could then be used to pinpoint them. This program could not be applied to the entire population...
December 2016: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/27795812/mucins-in-neoplasms-of-pancreas-ampulla-of-vater-and-biliary-system
#17
REVIEW
Dimitrios Moschovis, Giorgos Bamias, Ioanna Delladetsima
Tumors of the pancreas, the ampulla of Vater, and the extrahepatic and intrahepatic bile ducts have significant histological similarities due to the common embryonic origin of the pancreatobiliary system. This obviates the need for discovery of biomarkers with diagnostic and prognostic value for these tumors. Mucins, especially MUC-1, -2, -4 and -5AC, are important candidates for developing into such reliable biomarkers. Increased expression of MUC1 occurs in pancreatic ductal adenocarcinomas and is associated with increased degrees of dysplasia in pancreatic intraepithelial neoplasia (PanIN)...
October 15, 2016: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27783869/main-duct-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-developing-a-pancreaticogastric-fistula-while-in-follow-up
#18
Kwangwoo Nam, Jun-Ho Choi
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas runs along a large spectrum from benign adenoma to invasive carcinoma.(1) Fistulas between the pancreas and adjacent organs, such as the duodenum, bile duct, and stomach, have been reported,(2-4) but benign pancreaticogastric fistulas have rarely been reported.(5) Herein, we report a patient who was diagnosed with main duct type pancreatic IPMN complicated with spontaneous pancreaticogastric fistula formation. This article is protected by copyright...
October 26, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27756613/pancreatic-juice-cytology-with-immunohistochemistry-to-detect-malignancy-and-histologic-subtypes-in-patients-with-branch-duct-type-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#19
Shinsuke Koshita, Yutaka Noda, Kei Ito, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yoshiharu Masaki, Jun Horaguchi, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Miwa Uzuki, Fumiyoshi Fujishima
BACKGROUND AND AIMS: The aim of this study was to elucidate the efficacy of pancreatic juice cytology with the cell-block method (CB-PJC) for the determination of surgery in patients with branch duct intraductal papillary mucinous neoplasm (BD-IPMN). METHODS: In 138 patients with BD-IPMN from whom pancreatic juice was collected under ERCP for CB-PJC, we retrospectively evaluated the following: (1) the rate of successfully evaluated CB-PJC; (2) the ability of CB-PJC to diagnose malignancy and to identify pathologic subtypes in resected BD-IPMNs; (3) the rate of development into invasive cancer and progression of BD-IPMNs in patients with BD-IPMNs diagnosed as benignancy by CB-PJC; and (4) post-ERCP adverse events...
October 15, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27693645/comparing-3-guidelines-on-the-management-of-surgically-removed-pancreatic-cysts-with-regard-to-pathological-outcome
#20
Selma J Lekkerkerker, Marc G Besselink, Olivier R Busch, Joanne Verheij, Marc R Engelbrecht, Erik A Rauws, Paul Fockens, Jeanin E van Hooft
BACKGROUND AND AIMS: Currently, 3 guidelines are available for the management of pancreatic cysts. These guidelines vary in their indication for resection of high-risk cysts. We retrospectively compared the final pathologic outcome of surgically removed pancreatic cysts with the indications for resection according to 3 different guidelines. METHODS: Patients who underwent pancreatic resection were extracted from our prospective pancreatic cyst database (2006-present)...
September 29, 2016: Gastrointestinal Endoscopy
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