A Case of Intraductal Tubulopapillary Neoplasm of the Pancreas (ITPN) which with Difficult to Diagnose Preoperatively

Matsushita, Katsunori; Morimoto, Osakuni; Motoki, Yoshiyuki; Okano, Miho; Adachi, Shin‐ichi; Hirao, Takafumi; Takeuchi, Makoto; Fukuzaki, Takayuki; Shibata, Kunitaka

doi:10.5833/jjgs.2011.0312

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…In the past reported cases, there have been four cases with stromal invasion, 1 with liver metastasis, 1 with duodenal invasion, and 1 with portal vein tumor thrombus ( Table 2). [3][4][5][6][7] Although local invasions are reported even in the cases of small tumors, the tumor size is larger than the others in the two cases with liver metastasis. These facts suggest that ITPN grows relatively slowly but can invade outside the ducts and finally into the vessels.…”

Section: Discussionmentioning

confidence: 83%

“…Although ITPN is regarded as a premalignant lesion in WHO classification, this subtype could invade outside the duct. In the past reported cases, there have been four cases with stromal invasion, 1 with liver metastasis, 1 with duodenal invasion, and 1 with portal vein tumor thrombus (Table ) . Although local invasions are reported even in the cases of small tumors, the tumor size is larger than the others in the two cases with liver metastasis.…”

Section: Discussionmentioning

confidence: 98%

“…For example, although ITPN is classified among the premalignant lesions in the WHO classification and is considered indolent, there are a few cases with metastasis, local invasion and portal vein tumor thrombus. [3][4][5][6][7] Cases with atypical histological findings have also been reported. 4,[8][9][10][11] Here we describe the first case of ITPN with duodenal invasion and extensive calcification with foamy macrophage aggregation.…”

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confidence: 91%

“…However the clinicopathological features of ITPN have not been sufficiently clarified due to the small number of cases, so it is still necessary to collect more information of its prognosis, imaging and histological variations. For example, although ITPN is classified among the premalignant lesions in the WHO classification and is considered indolent, there are a few cases with metastasis, local invasion and portal vein tumor thrombus . Cases with atypical histological findings have also been reported .…”

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confidence: 99%

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A case of intraductal tubulopapillary neoplasm of pancreas with severe calcification, a potential pitfall in diagnostic imaging

Takayama

Maeda

Nishihara

et al. 2015

Pathology International

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We experienced a case of intraductal tubulopapillary neoplasms (ITPN) of the pancreas with severe calcification, which complicated image diagnosis. A pancreas head tumor was detected in a Japanese female in her 50s. Early enhancement by contrast-enhanced CT and coarse calcification suggested a neuroendocrine tumor, although the obstruction and dilation of the main pancreatic duct appeared to be an intraductal tumor. An endoscopic ultrasound-guided fine needle aspiration biopsy specimen revealed adenocarcinoma tissue. Pancreaticoduodenectomy was performed, and the patient has been well without evidence of recurrence for over 10 months. Pathological examination on the resected specimen revealed that the tumor showed papillary and tubulo-cribriform growth patterns. Together with typical immunohistochemical results, the final diagnosis of ITPN was made. Characteristically, this case showed extensive calcification of both psammoma body-type and non psammoma body-type with foamy macrophage aggregation. This is the first report of ITPN with two types of calcification and macrophage. Since calcification might be one of the characteristic histological findings in ITPN as shown in our case, the possibility of ITPN should be also considered when calcification is detected in pancreatic lesions by various imaging modalities.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 98%

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confidence: 91%

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confidence: 99%

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A case of intraductal tubulopapillary neoplasm of pancreas with severe calcification, a potential pitfall in diagnostic imaging

Takayama

Maeda

Nishihara

et al. 2015

Pathology International

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“…After applying our inclusion criteria, 68 articles were included in the systematic review (Figure S1). 11–78 …”

Section: Resultsmentioning

confidence: 99%

Intraductal tubulopapillary neoplasm (ITPN) of the pancreas: a distinct entity among pancreatic tumors

et al. 2022

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Intraductal tubulopapillary neoplasm (ITPN) of the pancreas: a distinct entity among pancreatic tumorsAims: Intraductal tubulopapillary neoplasm (ITPN) of the pancreas is a recently recognized pancreatic tumor entity. Here we aimed to determine the most important features with a systematic review coupled with an integrated statistical approach. Methods and results: PubMed, SCOPUS, and Embase were searched for studies reporting data on pancreatic ITPN. The clinicopathological, immunohistochemical, and molecular data were summarized. Then a comprehensive survival analysis and a comparative analysis of the molecular alterations of ITPN with those of pancreatic ductal adenocarcinoma (PDAC) and intraductal papillary mucinous neoplasm (IPMN) from reference cohorts (including the International Cancer Genome Consortium-ICGC dataset and The Cancer Genome Atlas, TCGA program) were conducted. The core findings of 128 patients were as follows: (i) Clinicopathological parameters: pancreatic head is the most common site; presence of an associated adenocarcinoma was reported in 60% of cases, but with rare nodal metastasis. (ii) Immunohistochemistry: MUC1 (>90%) and MUC6 (70%) were the most frequently expressed mucins. ITPN lacked the intestinal marker MUC2; unlike IPMN, it did not express MUC5AC. (iii) Molecular landscape: Compared with PDAC/IPMN, the classic pancreatic drivers KRAS, TP53, CDKN2A, SMAD4, GNAS, and RNF43 were less altered in ITPN (P < 0.001), whereas MCL amplifications, FGFR2 fusions, and PI3KCA mutations were commonly altered (P < 0.001). (iv) Survival analysis: ITPN with a "pure" branch duct involvement showed the lowest risk of recurrence. Conclusion: ITPN is a distinct pancreatic neoplasm with specific clinicopathological and molecular characteristics. Its recognition is fundamental for its clinical/prognostic implications and for the enrichment of potential targets for precision oncology.

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Clinicopathological features and surgical outcomes of intraductal tubulopapillary neoplasm of the pancreas: a systematic review

Date

Okabayashi

Shima

et al. 2016

Langenbecks Arch Surg

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A Case of Intraductal Tubulopapillary Neoplasm of the Pancreas (ITPN) which with Difficult to Diagnose Preoperatively

Cited by 6 publications

References 6 publications

A case of intraductal tubulopapillary neoplasm of pancreas with severe calcification, a potential pitfall in diagnostic imaging

A case of intraductal tubulopapillary neoplasm of pancreas with severe calcification, a potential pitfall in diagnostic imaging

Intraductal tubulopapillary neoplasm (ITPN) of the pancreas: a distinct entity among pancreatic tumors

Clinicopathological features and surgical outcomes of intraductal tubulopapillary neoplasm of the pancreas: a systematic review

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