In view of the high prevalence of DC careful inspection of the entire pancreatic gland is necessary for early detection of DC in patients with branch duct IPMNs, especially when worsening diabetes mellitus and an abnormal serum CA 19-9 level are manifested.
We conclude that the size criteria (> or =30 mm) to predict malignancy proposed in the international consensus guidelines is appropriate and resection or meticulous follow-up using cytological examination and MPD dilatation is needed in patients with flat branch duct IPMNs.
HighlightsAdenocarcinoma arising from a gastric duplication cyst is extremely rare.This is the 2nd asymptomatic case in the English literature.During our close observation of 4 years, malignant transformation had occurred from a gastric duplication cyst.When morphological change appears, we strongly recommend surgical treatment without delay.
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