Branch Duct Intraductal Papillary Mucinous Neoplasm of the Pancreas in Solid Organ Transplant Recipients

Gill, Kanwar R.; Peláez-Luna, Mario; Keaveny, Andrew P.; Woodward, Timothy A.; Mb, Wallace; Chari, Suresh T.; Smyrk, Thomas C.; Takahashi, Naoki; Clain, Jonathan E.; Levy, Michael J.; Pearson, Randall K.; Petersen, Bret T.; Topazian, Mark D.; Vege, Santhi Swaroop; Kendrick, Michael L.; Farnell, Michael B.; Raimondo, Massimo

doi:10.1038/ajg.2009.62

Cited by 24 publications

(28 citation statements)

References 14 publications

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“…A subsequent increase in size within a 6-month period would mandate resection. This approach also appears to be possible in patients who are immunosuppressed following solid organ transplant [6]. Subsequent cost-effectiveness analysis of applying these guidelines compared to either immediate surgery or no surveillance has suggested this strategy to be the superior approach [7].…”

Section: Surveillance Versus Resection In Low-risk Bt-ipmnsmentioning

confidence: 99%

Branch-Type Intraductal Papillary Mucinous Neoplasms: An Update

Garcea

Dennison

2011

Pancreatology

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Section: Surveillance Versus Resection In Low-risk Bt-ipmnsmentioning

confidence: 99%

Branch-Type Intraductal Papillary Mucinous Neoplasms: An Update

Garcea

Dennison

2011

Pancreatology

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“…They reported that only 9/82 (11%) of IPMNs exhibited an increase in cyst size (>10 mm) and 4/82 (4.9%) developed mural nodules, but none of these IPMNs developed invasive carcinomas. Recent prospective studies by Pelaez-Luna et al 33,34 revealed that malignancy was present in 9/61 (15%) of branch duct IPMNs with at least one of the consensus indications for resection (CIR; i.e., cystrelated symptoms, cyst size >30 mm, main pancreatic duct >10 mm, mural nodules, and positive cytology) and 0/16 of IPMNs without CIR, although their specifi city was low. Rautou et al 35 have reported that the only factor associated with the signs suggesting malignant transformation was an increase in cyst size to more than 5 mm during the follow-up of branch duct IPMNs.…”

Section: Natural History Of Ipmnsmentioning

confidence: 97%

“…Recent prospective studies of the natural history of IPMNs show that branch duct IPMNs with main duct dilatation, or a mural nodule, or of cyst size >30 mm should be indications for resection, whereas asymptomatic branch duct IPMN <30 mm without main duct dilatation and without a mural nodule can be followed using periodic imaging tests. [28][29][30][31][32][33][34][35] The recommendation by the international consensus guidelines in 2006 4 has been validated in the latest prospective studies and some large retrospective studies. 36,37 However, a prospective analysis by Walsh et al 38 revealed that cyst size alone is not a reasonable risk factor for malignancy.…”

Section: Natural History Of Ipmnsmentioning

confidence: 97%

“…[28][29][30][31][32][33][34][35] Tanno et al 32 evaluated the long-term follow-up results of 82 asymptomatic branch duct IPMNs without mural nodules. They reported that only 9/82 (11%) of IPMNs exhibited an increase in cyst size (>10 mm) and 4/82 (4.9%) developed mural nodules, but none of these IPMNs developed invasive carcinomas.…”

Section: Natural History Of Ipmnsmentioning

confidence: 99%

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Malignant potential of intraductal papillary mucinous neoplasms of the pancreas

2010

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An intraductal papillary mucinous neoplasm (IPMN) is now a well-recognized disease entity. In general, the prognosis of IPMN is much more favorable than that of pancreatic ductal adenocarcinoma (PDAC). However, IPMN has a broad biological spectrum and it sometimes progresses, slowly showing neoplastic transformations. International consensus guidelines have been recently proposed for the management of IPMN. While they significantly contribute to appropriate management of IPMN, various issues including the natural history and malignant potential of IPMN are not fully elucidated. This review focuses on the malignant potential, including the postoperative recurrence of IPMN, coincidence of IPMN with PDAC, and extrapancreatic malignancy that may affect the long-term survival of the patients rather than IPMN itself.

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“…This confirms two recent short studies. 13,14 However, the question whether IPMN in immunocompromised patients deserves a closer follow-up remains open.…”

Section: Discussionmentioning

confidence: 99%

Estimation of the prevalence of intraductal papillary mucinous neoplasm of the pancreas in the French population through patients waiting for liver transplantation

Laurent¹,

Vullierme²,

Rebours³

et al. 2015

Pancreatology

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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. All consecutive patients placed on the French liver transplant waiting list who had MRI for a non-pancreatic disease before liver transplantation between 2009 and 2013 were included. Only diagnoses consistent with IPMN were retained (cyst(s) clearly communicating with the main pancreatic duct). Results: Among 315 patients on the national waiting list, 212 patients had an MRI. PCLs with ductal communication were diagnosed in 14 patients (6.6%; six women, eight men, median age 62 years (45-70)). Liver disease was caused by a virus in seven cases, alcohol in three cases, other in four cases (multiple causes possible). Four patients had hepatocellular carcinoma. No patient had clinical or radiological sign of chronic pancreatitis. The median diameter of the largest cystic lesion was 14 mm (7-22). The number of PCLs was one (n ¼ 4), two (n ¼ 2), four (n ¼ 3), five (n ¼ 2), > 5 (n ¼ 3), respectively. There was no worrisome or main pancreatic duct involvement. Conclusions: Prevalence of pancreatic cystic lesions consistent with the diagnosis of IPMN was 6.6% in French patients waiting for liver transplantation. These results underscore that IPMN can be considered as a public health problem and justify a screening.

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Branch Duct Intraductal Papillary Mucinous Neoplasm of the Pancreas in Solid Organ Transplant Recipients

Abstract: In participants with IPMN-Br, short-term follow-up after solid organ transplant was not associated with any significant change in cyst characteristics suggesting that incidental IPMN-Br, even in the setting of immunosuppression post-transplant, can be followed conservatively.

Cited by 24 publications

References 14 publications

Branch-Type Intraductal Papillary Mucinous Neoplasms: An Update

Branch-Type Intraductal Papillary Mucinous Neoplasms: An Update

Malignant potential of intraductal papillary mucinous neoplasms of the pancreas

Estimation of the prevalence of intraductal papillary mucinous neoplasm of the pancreas in the French population through patients waiting for liver transplantation

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