Intraductal papillary mucinous neoplasms of the pancreas with concurrent pancreatic and periampullary neoplasms

详细信息    查看全文

• 作者：K. Sahora^a ; ^b ; S. Crippa^c ; ^d ; ¹ ; G. Zamboni^d ; C. Ferrone^a ; ^b ; A.L. Warshaw^a ; ^b ; K. Lillemoe^a ; ^b ; M. Mino-Kenudson^b ; M. Falconi^c ; ^d ; ¹ ; C. Fernandez-del Castillo^a ; ^b ; ^{cfernandez@partners.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Pancreas ; Intraductal papillary mucinous noeplasm ; Concurrent neoplasm ; Pancreatic cancer
• 刊名：European Journal of Surgical Oncology (EJSO)
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：42
• 期：2
• 页码：197-204
• 全文大小：527 K

文摘

Intraductal papillary mucinous neoplasms (IPMN) have been reported to be associated with concurrent, distinct pancreatic ductal adenocarcinoma (con-PDAC) in about 8% (range, 4–10%) of resected branch duct (BD) lesions. In addition, other pancreatic and ampullary tumors are occasionally diagnosed with IPMN in patients undergoing pancreatic surgery. The objective of this study is to describe the prevalence, clinicopathologic characteristics and prognosis of IPMN with concurrent pancreatic and ampullary neoplasms, especially con-PDAC.

Methods

The combined databases of pancreatic resections from the Massachusetts General Hospital and the Negrar Hospital, Italy, were analyzed for patients who had been diagnosed with IPMN and concurrent pancreatic or ampullary neoplasms.

Results

2762 patients underwent pancreatic surgery from January 2000 to December 2012. Sixteen percent (n = 441) had pathologically confirmed IPMN and 11% of these (n = 50) had a different distinct synchronous pancreatic neoplasm. The majority of these, 62%, were con-PDAC, followed by neuroendocrine neoplasms (10%) and ampullary carcinoma (10%). Less frequently, mucinous (6%) as well as serous cystic neoplasms (6%), adenosquamous carcinoma (4%) and distal bile duct cancer (2%) were diagnosed. Among all patients with synchronous neoplasms, 66% harbored BD-IPMN, 28% combined IPMN and 6% main duct IPMN. Abdominal pain and/or jaundice were the leading symptoms in half of patients.

Conclusion

IPMN, mainly BD-IPMN, are associated with con-PDAC in about 7% of patients and account for 62% of all concurrent pancreatic/ampullary neoplasms. Other synchronous neoplasms may be found sporadically with IPMN without a suspected association.