The Landmark Series: Intraductal Papillary Mucinous Neoplasms of the Pancreas—From Prevalence to Early Cancer Detection

Abstract

Modern series report a prevalence of pancreatic cysts in the general population of up to 50% in prospective studies. Of these, about half will be pancreatic cystic neoplasms (PCNs) that have varying degrees of malignant potential. Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are the most common PCNs and are known predecessors of pancreatic adenocarcinoma. Critically, they are one of the only radiographically identifiable precursors of pancreatic cancer and thus provide an opportunity for early cancer detection and surgical resection with curative intent. The combination of high prevalence and potential for malignant degeneration underscore the relevance of discussing the best management of IPMNs and improving the existing standard of care. Landmark data on IPMN prevalence, guidelines, surveillance, biomarkers, and immune landscape are highlighted.

Multi-omic profiling of intraductal papillary neoplasms of the pancreas reveals distinct expression patterns and potential markers of progression

“…IPNs, including intraductal papillary mucinous neoplasms (IPMNs), intraductal oncocytic papillary neoplasms (IOPNs) and intraductal tubulopapillary neoplasms (ITPNs), are macroscopic non-invasive precursor lesions, some of which progress to invasive pancreatic cancer [10][11][12][13][14] . IPNs form cysts in the pancreas, and these cysts are detectable with currently available imaging technologies 15 .…”

A Simple Overview of Pancreatic Cancer Treatment for Clinical Oncologists

“…Its poor prognosis is mainly due to early systemic spread, local aggressiveness and the poor efficacy of actual treatments. PDAC arises through multiple steps from precursor lesions to undergoing progression from low-grade to high-grade dysplastic lesions and acquiring increasing cytological atypia and genetic aberrations [7][8][9]. Generally, two main types of PDAC precursor lesions are recognized: pancreatic intraepithelial neoplasias (PanINs, 85-90%) and cystic lesions of the pancreas.…”

“…Generally, two main types of PDAC precursor lesions are recognized: pancreatic intraepithelial neoplasias (PanINs, 85-90%) and cystic lesions of the pancreas. Cystic pancreatic lesions include intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) [7][8][9]. Generally, cystic neoplasms of the pancreas can be diagnosed via imaging techniques; on the contrary, the detection of PanINs is not possible using abdominal imaging scans [10].…”