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Background & Aims
Mucin-producing neoplasms (MPNs) of the pancreas include mucinous cystic neoplasms (MCNs) and main-duct, branch-duct, and combined intraductal papillary mucinous neoplasms (IPMNs). MCNs and branch-duct IPMNs are frequently confused; it is unclear whether main-duct, combined, and branch-duct IPMNs are a different spectrum of the same disease. We evaluated their clinical and epidemiologic characteristics.
Methods
Patients who underwent resection for histologically confirmed MPNs were identified (N = 557); specimens were reviewed and eventually reclassified.
Results
One hundred sixty-eight patients (30 % ) had MCNs, 159 (28.5 % ) had branch-duct IPMNs, 149 (27 % ) had combined IPMNs, and 81 (14.5 % ) had main-duct IPMNs. Patients with MCNs were significantly younger and almost exclusively women; 44 % of patients with main-duct or combined IPMNs and 57 % of those with branch-duct IPMNs were women. MCNs were single lesions located in the distal pancreas (95 % ); 11 % were invasive. IPMNs were more frequently found in the proximal pancreas; invasive cancer was found in 11 % , 42 % , and 48 % of branch-duct, combined, and main-duct IPMNs, respectively (P = .001). Patients with invasive MCN and those with combined and main-duct IPMNs were older than those with noninvasive tumors. The 5-year disease-specific survival rate approached 100 % for patients with noninvasive MPNs. The rates for those with invasive cancer were 58 % , 56 % , 51 % , and 64 % for invasive MCNs, branch-duct IPMNs, main-duct IPMNs, and combined IPMNs, respectively.
Conclusions
MPNs comprise 3 different neoplasms: MCNs, branch-duct IPMNs, and main-duct IPMNs, including the combined type. These tumors have specific clinical, epidemiologic, and morphologic features that allow a reasonable degree of accuracy in preoperative diagnosis.
