Intraductal Papillary Mucinous Tumors of the Pancreas

Sugiyama, Masanori; Atomi, Yutaka

doi:10.1097/00000658-199811000-00008

Cited by 249 publications

(210 citation statements)

References 22 publications

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“…Sin embargo la presencia de compromiso multifocal o difuso a lo largo del conducto se observa en 33% de los pacientes 15 . Presencia de atipia, cáncer in situ o cáncer invasor se observa en 60% de las piezas resecadas 12 , variando este porcentaje de acuerdo a las series entre 52% y 88% 16,17 .…”

Section: Tumor Intraductal Papilar Mucinoso (Tipm)unclassified

“…El tratamiento de estos tumores consiste en la resección de la glándula incluyendo la lesión. La resecabilidad de estas lesiones es superior a 88% en los casos de adenocarcinoma y 100% en los casos de adenomas 17 . Un problema frecuentemente encontrado al momento de la resección lo constituye el límite de sección de la glándula.…”

Section: Colangiopancreatografía Endoscópica Retrógradaunclassified

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Tumores quísticos del páncreas

et al. 2008

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Cystic tumors of the pancreas (Rev Méd Chile 2008; 136: 1188-96L os tumores de la glándula pancreática se caracterizan en general por su diagnóstico tardío y mal pronóstico. El tumor pancreático más común es el adenocarcinoma de los conductos y su sobrevida promedio no sobrepasa 5% a 5 años [1][2][3][4] .Durante los últimos años, ha sido posible el diagnóstico de una mayor cantidad de lesiones denominadas «incidentalomas», de las cuales las lesiones quísticas pancreáticas representan una importante proporción.Este fenómeno ha sido claramente descrito por el grupo del Massachussets General Hospital, quienes comunican cómo ellos han duplicado las resecciones pancreáticas efectuadas por tumores quísticos durante la última década 5 . Igual tendencia se observa en el reporte efectuado por Allen, de la experiencia del Memorial Sloan Kettering Center, quienes muestran un aumento en los casos evaluados, con 5 casos en 1995 comparado con 117 en 2004 6 .Debido al aumento en su diagnóstico y a las dificultades que su identificación ofrece, hemos querido analizar las principales características clí-nicas, radiológicas y patológicas de las lesiones más frecuentes del páncreas, con énfasis en todas aquellas diferentes al adenocarcinoma ductal. Tumor intraductal papilar mucinoso (TIPM).Constituye entre 20% y 30% de los tumores quísticos pancreáticos. Se caracteriza por desarrollarse a partir del epitelio del conducto pancreático principal o de alguna de sus ramas y por presentar secreción mucinosa espesa que se asocia a dilatación tanto del conducto como a la formación de quistes 7,8 .Esta lesión fue primeramente descrita en Japón en 1982 por Ohhashi 9 . El término TIPM fue dado recién en 1996 y 1997 por la Organización Mundial de la Salud y el Instituto de Patología de las Fuerzas Armadas, respectivamente 10,11 .Afecta con igual frecuencia a ambos sexos y mayoritariamente a pacientes en la sexta y séptima década 12 .

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Section: Tumor Intraductal Papilar Mucinoso (Tipm)unclassified

Section: Colangiopancreatografía Endoscópica Retrógradaunclassified

Tumores quísticos del páncreas

et al. 2008

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“…According to the Guidelines, surgical resection is recommended for all main duct IPMNs because of the high risk of malignancy (61.6%) and invasive carcinoma (43.1%) 3,4) . Long-term survival for completely resected IPMNs is markedly better than that of invasive ductal carcinoma of the pancreas [5][6][7][8][9][10] , whereas some reported invasive IPMNs behave as aggressively as invasive ductal carcinoma 11) . The recurrence rate of invasive IPMNs after complete resection ranges from 40 to 65% of patients, and lymph node involvement, vascular invasion, positive surgical margin, and existence of jaundice are prognostic factors 12,13) .…”

Section: Introductionmentioning

confidence: 99%

Intranuclear accumulation of galectin-3 is associated with a poor prognosis in patients with invasive intraductal papillary mucinous neoplasm

Shimura

Kofunato

Okada

et al. 2016

Ann. Cancer Res. Therap.

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Results:The intranuclear accumulation of galectin-3 (gal-3-INA) was more frequently encountered in patients with invasive IPMN than with non-invasive IPMN (P = 0.038). Incidences of background fibrosis and dilatation of the main pancreatic duct were higher in the high-galectin-3 expression group than in the low-galectin-3 expression group (P = 0.0041 and 0.006, respectively). Incidence of background fibrosis was also higher in patients with gal-3-INA than without gal-3-INA (P = 0.011). The presence of gal-3-INA was higher in the high-galectin-3 expression group than in the low-galectin-3 expression group (P = 0.014). The high-galectin-3-expression group and the patients with gal-3-INA had a significantly poorer prognosis than the low-galectin-3-expression group and those without gal-3-INA (P = 0.020 and P = 0.014, respectively). Multivariate analysis using a Cox regression model revealed that gal-3-INA was an independent prognostic factor (hazard ratio: 5.162, 95% confidential interval: 1.033-25.807, P = 0.046). Conclusions:The presence of gal-3-INA is an independent prognostic factor for patients with invasive IPMN.

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“…Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas, which was first reported by Ohashi et al in 1982, originates from epithelial cells of the main pancreatic duct or its side branches and produces large amounts of mucin (1)(2)(3)(4). IPMN presents at various histopathological stages from benign to malignant lesions, as classified by the WHO, including adenoma, borderline, carcinoma in situ (CIS), and invasive carcinoma (5,6).…”

Section: Introductionmentioning

confidence: 99%

Utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in differential diagnosis of benign and malignant intraductal papillary-mucinous neoplasm of the pancreas

et al. 2010

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Abstract. Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas presents in various histopathological stages from benign to malignant lesions. The differentiation between benign and malignant IPMN is important in order t o determine the treatment of the patients. However, preoperative differentiation remains difficult. The aim of this study was to assess the utility of 2-[18 F] fluoro-2-deoxy-Dglucose positron emission tomography (FDG-PET) in preoperative differentiation of benign and malignant IPMN of the pancreas. In the present study we prospectively investigated 29 patients who underwent CT, FDG-PET, and surgery for IPMNs, followed by histopathological examination. The maximum standardized uptake value (SUVmax) was determined on FDG-PET, and differentiation of benign from malignant IPMN was tested using various SUVmax cut-off levels and various parameters derived from the CT. SUVmax was found to be significantly higher in malignant IPMNs (4.7±3.0) than that in benign IPMNs (1.8±0.3, P=0.0011). SUVmax values correlated with the histopathological types of IPMN (adenoma/borderline lesion/carcinoma in situ/invasive carcinoma) (Spearman rank correlation 0.865, P<0.0001). The specificity, sensitivity and accuracy values were best for SUVmax of 2.5 (100, 93, and 96%, respectively). The combination of mural nodule, detected on CT, and SUVmax of 2.5 offered the best diagnosis of malignant IPMN. These results suggest that FDG-PET is useful for differentiation of malignant IPMN of the pancreas, and that it should be performed in combination with other conventional imaging modalities.

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Intraductal Papillary Mucinous Tumors of the Pancreas

Abstract: IPMT has a favorable prognosis, regardless of deep invasion or node metastasis. IPMT requires peripancreatic node dissection in addition to complete tumor excision. Node dissection may be omitted for branch duct tumors less than 30 mm without mural nodules.

Cited by 249 publications

References 22 publications

Tumores quísticos del páncreas

Tumores quísticos del páncreas

Intranuclear accumulation of galectin-3 is associated with a poor prognosis in patients with invasive intraductal papillary mucinous neoplasm

Utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in differential diagnosis of benign and malignant intraductal papillary-mucinous neoplasm of the pancreas

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