Intraductal Papillary Mucinous Neoplasms and Chronic Pancreatitis

Talamini, Giorgio; Zamboni, Giuseppe; Salvia, Roberto; Capelli, Paola; Sartori, Nora; Casetti, Luca; Bovo, P.; Vaona, B.; Falconi, Massimo; Bassi, Claudio; Scarpa, Aldo; Vantini, Italo; Pederzoli, Paolo

doi:10.1159/000097605

Cited by 52 publications

(37 citation statements)

References 23 publications

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“…Potential risk factors include chronic pancreatitis. In an attempt to see if patients with chronic pancreatitis were at risk for IPMN, Talamini and colleagues [17] reported a long-term study of patients diagnosed with chronic pancreatitis between 1981 and 1998. A total of 476 patients were identified, 93 of whom had chronic obstructive pancreatitis and 46 had biopsy-proven IPMN.…”

Section: Risk Factorsmentioning

confidence: 99%

Population-based epidemiology, risk factors and screening of intraductal papillary mucinous neoplasm patients

Khan¹

2010

WJGS

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Intraductal papillary mucinous neoplasm (IPMN) was first recognized in the 1980s with increasing publications over the last decade as the incidence increased sharply, especially at tertiary-care referral centers. Populationbased studies have estimated the age and sex-adjusted cumulative incidence of IPMN to be 2.04 per 100 000 person-years (95% confidence interval: 1.28-2.80). It is now understood that IPMN can be classified anywhere along the spectrum of the adenoma to carcinoma sequence and often harbors mutations in genes such as KRAS early in the disease process. Many patients are diagnosed incidentally after imaging of the abdomen for other diagnostic purposes. Patients that present with a history of symptoms such as pancreatitis and abdominal pain are at high risk of harboring a malignancy. CliniOctober 27, 2010|Volume 2|Issue 10| copathologic features such as involvement of the main pancreatic duct, presence of mural nodules, and side branch disease > 3.0 cm in size may indicate that there is an underlying invasive component to the IPMN. In addition, the incidence of extra-pancreatic neoplasms is higher in patients with IPMN, with reported rates of 25% to 50%. There are no current screening recommendations to detect and diagnose IPMN but once the diagnosis is made, screening for extrapancreatic neoplasms such as colon polyps and colorectal cancer should be considered. Surgical resection is the recommend treatment for patients with high-risk features while close observation can be offered to patients without worrisome signs and symptoms of carcinoma.

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Section: Risk Factorsmentioning

confidence: 99%

Population-based epidemiology, risk factors and screening of intraductal papillary mucinous neoplasm patients

Khan¹

2010

WJGS

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“…Twelve to sixty percent of patients with IPMN have a history leading to a diagnosis of chronic pancreatitis [4,5] and roughly 2% of all diagnoses of chronic pancreatitis are associated with IPMN [5] . However, few reports of patients with concomitant calcyfing pancreatitis and IPMN are available [2,3] .…”

Section: To the Editormentioning

confidence: 99%

“…However, few reports of patients with concomitant calcyfing pancreatitis and IPMN are available [2,3] . In a cohort study of 473 patients suffering from chronic pancreatitis, only 6 were found to have IPMN during follow-up but none had calcifications [5] . Of the 16 cases of patients with IPMN and pancreatic calcification published thus far, 8 had diffuse pancreatic calcification which did not involve the tumor itself in most of the cases [2,3] .…”

Section: To the Editormentioning

confidence: 99%

“…In any case, the concomitant presence of pancreatic cystic lesions, duct dilatation, and calcification should raise the suspicion of an IPMN. Particular care should be taken when diagnosing chronic pancreatitis in patients who do not present typical characteristics of the disease, namely age over 50 years, moderate alcohol intake, and non-smokers, which may be suggestive of IPMN [5] . In our case, the patient was 81 years of age and did not consume any alcohol as verified by the patient himself and his relatives.…”

Section: To the Editormentioning

confidence: 99%

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Intraductal papillary mucinous neoplasm in chronic calcifying pancreatitis: Egg or hen?

Kalaitzakis¹,

Braden²,

Trivedi³

et al. 2009

WJG

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Intraductal papillary mucinous neoplasm (IPMN) is an increasingly reported entity. Extensive pancreatic calcification is generally thought to be a sign of chronic pancreatitis, but it may occur simultaneously with IPMN leading to diagnostic difficulties. We report a case of a patient initially diagnosed with chronic calcifying pancreatitis who was later shown to have a malignant IPMN. This case illustrates potential pitfalls in the diagnosis of IPMN in the case of extensive pancreatic calcification as well as clues that may lead the clinician to suspecting the diagnosis. The possible mechanisms of the relation between pancreatic calcification and IPMN are also reviewed.

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“…Talamini et al [3][4][5] prospectively followed 473 patients with chronic pancreatitis, including 45 cases of IPMN, and found that approximately 12% of patients with IPMN have a history leading to a diagnosis of chronic pancreatitis, and roughly 2% of all chronic pancreatitis diagnoses are associated with IPMN. The misdiagnosis of IPMN as chronic pancreatitis can lead to serious delays in appropriate management.…”

mentioning

confidence: 99%

MRCP Imaging of Intraductal Papillary-Mucinous Neoplasm of the Pancreas

Kantarcı

Bayraktutan

Yılmaz

et al. 2012

EAJM

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A 79-year-old man was admitted to the hospital with complaints of abdominal discomfort, jaundice and weight loss. His physical examination was unremarkable, but laboratory examinations revealed significant findings indicating steatorrhea and cholestasis. An ultrasound (US) study revealed marked dilatation of the main bile duct and bile duct as well as the associated branches, with no mass in the pancreatic head. A distended gallbladder was also observed on US. A magnetic resonance cholangiopancreatography (MRCP) revealed dilatation of the main pancreatic duct and side branches with irregular mural thickening and several filling defects ( Figure A). These trends were also observed in 3-D volume rendering images ( Figure B). Secondary to these findings, the gallbladder was distended, and the bile ducts were dilated. No mass was identified in the pancreas. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP), and histopathological examination of the biopsy revealed intraductal papillary-mucinous neoplasm (IPMN).Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is characterized by the presence of a mucin-producing tumor and cystic dilatation of the branches of the pancreatic duct in the uncinate process (branch duct type), diffuse or segmental dilatation of the main pancreatic duct (main duct type) or dilatation of the main ducts and branch ducts (combined type). The dilated ducts often contain profuse mucin. This tumor is also known as a mucin-producing pancreatic tumor, mucinous ductal ectasia, intraductal mucin-hypersecreting tumor or ductectatic mucinous cystic tumor [1][2]. Dilatation of the main pancreatic duct and side branches led to diagnosis of combined-type IPMN.MRCP is especially helpful for staging and as a road map to surgical and percutaneous intervention. Because the A B

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Intraductal Papillary Mucinous Neoplasms and Chronic Pancreatitis

Cited by 52 publications

References 23 publications

Population-based epidemiology, risk factors and screening of intraductal papillary mucinous neoplasm patients

Population-based epidemiology, risk factors and screening of intraductal papillary mucinous neoplasm patients

Intraductal papillary mucinous neoplasm in chronic calcifying pancreatitis: Egg or hen?

MRCP Imaging of Intraductal Papillary-Mucinous Neoplasm of the Pancreas

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