“High-Risk Stigmata” of the 2012 International Consensus Guidelines Correlate With the Malignant Grade of Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas

Abstract

The number of high-risk stigmata correlated significantly with the grade of malignancy of BD-IPMNs. The presence of at least 1 high-risk stigma in patients with BD-IPMNs indicates a need for pancreatectomy with lymphadenectomy.

Accuracy of 2012 International Consensus Guidelines for the prediction of malignancy of branch-duct intraductal papillary mucinous neoplasms of the pancreas

“…There was no stepwise increase in rates of malignant or invasive IPMN with the number of WFs. A recent study published by Aso et al in 2014 reported that the likelihood of malignant BD-IPMN increased in accordance with the number of high-risk stigmata, 9 whereas the number of WF was not significantly correlated with malignancy. In our study, patients with only one predictive factor according to ICG guidelines had a malignancy rate of 15%.…”

Chronic Pancreatitis Finding by Endoscopic Ultrasonography in the Pancreatic Parenchyma of Intraductal Papillary Mucinous Neoplasms Is Associated with Invasive Intraductal Papillary Mucinous Carcinoma

“…Patients who have "worrisome features" and additional high-risk signs should also undergo resection, while patients with "worrisome features" alone should receive careful follow-up. The "high-risk stigmata" of IPMNs that can be detected by endoscopic ultrasonography (EUS) are an enhancing solid component inside the cyst and dilation of the main pancreatic duct (>10 mm) [3,[8][9][10][11] . Additional high-risk signs among the "worrisome features" are a definite mural nodule and suspected main duct involvement [12,13] .…”

Management of branch-duct intraductal papillary mucinous neoplasms: a large single-center study to assess predictors of malignancy and long-term outcomes

“…Other imaging modalities like CT and MRI remain the first line of investigations in the majority of patients with an expanding body of literature backing this practice. [4][5][6][7][8][9][10] EUS has been suggested to be the most reliable tool for the characterization of IPMNs. 11 The ICG 2012 recommends possible EUS-FNA for evaluation of small BD-IPMNs without WF only in centers with expertise in EUS-FNA and cytological interpretation.…”