Pseudomyxoma peritonei accompanied by intraductal papillary mucinous neoplasm of the pancreas

Mizuta, Yohei; Akazawa, Yuko; Shiozawa, Ken; Ohara, Hiroshi; Ohba, Kazuo; Ohnita, Ken; Isomoto, Hajime; Takeshima, Fuminao; Omagari, Katsuhisa; Tanaka, Kenji; Yasutake, Tohru; Nakagoe, Tohru; Shirono, Kenji; Kohno, Shigeru

doi:10.1159/000086551

Cited by 44 publications

(18 citation statements)

References 13 publications

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“…18 As intra-abdominal rupture was followed by peritoneal dissemination in these reported cases, this type should be distinguished from ordinary IPMN and managed separately as ruptured IPMN.…”

Section: Pathologic Examinationmentioning

confidence: 74%

Minimally Invasive Intraductal Papillary-mucinous Carcinoma of the Pancreas: Clinicopathologic Study of 104 Intraductal Papillary-mucinous Neoplasms

Nara¹,

Shimada

Kosuge

et al. 2008

American Journal of Surgical Pathology

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Invasive intraductal papillary-mucinous carcinoma (I-IPMC) is a heterogeneous entity with various postoperative outcomes. The aim of this study is to characterize early-stage I-IPMC with nonaggressive characteristics. One hundred and four patients with intraductal papillary-mucinous neoplasm (IPMN) were clinicopathologically investigated. The lesions were classified into 53 noninvasive IPMNs (adenoma, borderline, and noninvasive IPMC) and 51 I-IPMCs on the basis of the WHO classification. I-IPMCs were divided further into 26 minimally invasive IPMCs (MI-IPMCs) and 25 invasive carcinomas originating in IPMC (IC-IPMCs) by new diagnostic criteria proposed in this study. We examined invasiveness of I-IPMC on 4 patterns, and defined simple and practical diagnostic criteria of minimal invasion for each invasive pattern. The disease-specific survival rates after 3, 5, and 10 years were 100%, 100%, and 100% for both noninvasive IPMN and MI-IPMC, and 51%, 38%, and 0% for IC-IPMC. The overall and disease-specific survival rates for MI-IPMC were both significantly better than those for IC-IPMC (P<0.001), but there was no significant difference between noninvasive IPMN and MI-IPMC. Multivariate analysis showed that the factors indicative of poor prognosis were a diagnosis of I-IPMC classified as IC-IPMC and a high level of serum carbohydrate antigen 19-9. The prognosis of IC-IPMC was not significantly different from that of pancreatic ductal carcinoma in each of the corresponding tumor-node-metastasis stages. These findings suggest that a category of MI-IPMC provides more accurate and useful information of the stage and the aggressiveness of I-IPMC.

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Section: Pathologic Examinationmentioning

confidence: 74%

Minimally Invasive Intraductal Papillary-mucinous Carcinoma of the Pancreas: Clinicopathologic Study of 104 Intraductal Papillary-mucinous Neoplasms

Nara¹,

Shimada

Kosuge

et al. 2008

American Journal of Surgical Pathology

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“…[ 15 ] Since then, four more cases of pseudomyxoma peritonei originating from IPMN of the pancreas have been reported. [ 11, 16-18 ] As so few cases have been described, further study is indicated to determine the significance of peritoneal or lesser sac infiltration of mucin. Herein, we present two cases at our institution of extra-pancreatic mucus from a primary IPMN of the pancreas.…”

Section: Introductionmentioning

confidence: 99%

Intraductal Papillary Mucinous Neoplasm (IPMN) with Extra-Pancreatic Mucin: A Case Series and Review of the Literature

Rosenberger

Stein

Witkiewicz

et al. 2012

Journal of Gastrointestinal Surgery

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Background Intraductal papillary mucinous neoplasm (IPMN) is an increasingly recognized pancreatic neoplasm characterized by excessive mucin secretion by ductal epithelial cells resulting in a cystic dilation of the pancreatic duct. Aim The objective of this study was to review Thomas Jefferson University’s experience and the literature to determine the significance of extra-pancreatic mucin when associated with an IPMN. Results A retrospective analysis at our institution revealed only two cases of IPMN associated with extra-pancreatic mucin, which were classic IPMNs with rupture of the pancreatic duct and peritoneal mucin spillage. This specific finding is not previously described, although is assumed as five cases were reported in the literature with IPMN and mucin extension demonstrated by pseudomyxoma peritonei (PMP). We propose IPMN of the pancreas may be grossly compared to a mucocele of the appendix, as both are characterized by excessive secretion of mucin by ductal epithelial cells. A morbid complication of a mucocele is PMP. The presence of extra-pancreatic mucin with an IPMN could present a rare but important marker of the eventual seeding of tumor outside the primary IPMN. This has been documented with cases of iatrogenic spilling of pancreatic mucin, as well as multiple cases of IPMN associated with pseudomyxoma peritonei. Conclusions At this time, there is scant reporting and consensus for the treatment of IPMN with extra-pancreatic mucin.

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“…Most cases derive from appendiceal mucinous tumors and show strong expression of CK20 but negative or weak expression of CK7. There are also a few cases of PMP associated with pancreatic IPMNs [6][7][8]13]. In our case, the patient had remained disease free for 6 years after surgical treatment of the IPNB and recurred as PMP with diffuse peritoneal seedings.…”

Section: Discussionmentioning

confidence: 65%

“…Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas (pancreatic IPMNs) are characterized by intraductal papillary proliferation of mucinous epithelia growing within cystically dilated pancreatic ducts. A few cases of IPMNs had PMP as their initial clinical presentation or as recurrences [2,7,8].…”

Section: Introductionmentioning

confidence: 99%

Pseudomyxoma peritonei (mucinous carcinoma peritonei) preceded by intraductal papillary neoplasm of the bile duct

Jhuang¹,

Hsieh²

2012

Human Pathology

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Pseudomyxoma peritonei accompanied by intraductal papillary mucinous neoplasm of the pancreas

Cited by 44 publications

References 13 publications

Minimally Invasive Intraductal Papillary-mucinous Carcinoma of the Pancreas: Clinicopathologic Study of 104 Intraductal Papillary-mucinous Neoplasms

Minimally Invasive Intraductal Papillary-mucinous Carcinoma of the Pancreas: Clinicopathologic Study of 104 Intraductal Papillary-mucinous Neoplasms

Intraductal Papillary Mucinous Neoplasm (IPMN) with Extra-Pancreatic Mucin: A Case Series and Review of the Literature

Pseudomyxoma peritonei (mucinous carcinoma peritonei) preceded by intraductal papillary neoplasm of the bile duct

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