Strategy in intraductal papillary mucinous neoplasm of the pancreas

• Published in: Gastroenterología y hepatología Vol. 35; no. 9; p. 652
• Main Authors: Navarro Colás, Salvador, Vaquero Raya, Eva C
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.11.2012
• Subjects: Adenocarcinoma, Mucinous - diagnosis; Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Mucinous - surgery; Adenoma - diagnosis; Adenoma - pathology; Adenoma - surgery; Aged; Algorithms; Biomarkers, Tumor - analysis; Carcinoma in Situ - diagnosis; Carcinoma in Situ - pathology; Carcinoma in Situ - surgery; Carcinoma, Pancreatic Ductal - diagnosis; Carcinoma, Pancreatic Ductal - pathology; Carcinoma, Pancreatic Ductal - surgery; Cyst Fluid - chemistry; Cyst Fluid - cytology; Diagnostic Imaging; Dilatation, Pathologic - diagnosis; Dilatation, Pathologic - etiology; Dilatation, Pathologic - surgery; Disease Management; Female; Humans; Male; Middle Aged; Pancreatectomy - methods; Pancreatic Cyst - diagnosis; Pancreatic Cyst - pathology; Pancreatic Cyst - surgery; Pancreatic Ducts - pathology; Pancreatic Ducts - surgery; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - prevention & control; Pancreatic Neoplasms - surgery; Pancreatitis - etiology; Precancerous Conditions - diagnosis; Precancerous Conditions - pathology; Precancerous Conditions - surgery; Prognosis; Risk Factors; Symptom Assessment
• ISSN: 0210-5705
• DOI: 10.1016/j.gastrohep.2012.05.009

Intraductal papillary mucinous neoplasm (IPMN) is a premalignant pancreatic entity characterized by papillary growth of the ductal epithelium with rich mucin production and cystic dilatation of the main pancreatic duct and/or its branches. These neoplasms are often multifocal. Preoperative distinction between benign and malignant lesions is important to select the most appropriate treatment and to improve prognosis. Early surgical resection is the treatment of choice to avoid malignant transformation when predictive factors for malignancy are present. These factors include localization, cyst greater than 3cm, nodules in the cystic wall, atypias in the cyst fluid and the presence of symptoms. The extent of resection required for adequate treatment of IPMN of the pancreas is still controversial. Patients who retain a portion of their pancreas following resection of an IPMN need to be followed up with periodic imaging to detect recurrences, signs indicating a risk of malignant transformation, and metachronous lesions. The existence of possible synchronous or metachronous lesions in other organs should also be investigated.