Pancreatic Ductal Adenocarcinoma Concomitant with Intraductal Papillary Mucinous Neoplasm: a Report of 8 Cases

Overview

Journal Clin J Gastroenterol

Specialty Gastroenterology

Date 2015 Jul 17

PMID 26181604

Citations 3

Authors

Koichiro Mandai

Koji Uno

Kenjiro Yasuda

Affiliations

Soon will be listed here.

Abstract

Branch-duct intraductal papillary mucinous neoplasm (BD-IPMN) is recognized as a risk factor for pancreatic ductal adenocarcinoma (PDAC) that is unrelated to the malignant transformation of IPMN. We experienced 8 cases of resected PDAC concomitant with IPMN from March 1988 to December 2012, and 7 patients had >2 risk factors, including IPMN, for pancreatic cancer. Seven of the IPMNs were <30 mm in size, while none had mural nodules. Four cases of PDAC were detected during the follow-up period for BD-IPMN. Neither magnetic resonance cholangiopancreaticography nor contrast-enhanced computed tomography performed 5 months prior to the detection of PDAC resulted in its early detection in 2 cases. The clinical features of the 8 cases indicate that particular attention is required for patients with >1 risk factor, in addition to IPMN, for pancreatic cancer. A shorter interval of surveillance than that suggested by the international consensus guidelines 2012 is required, even if the IPMNs are small, for the early detection of PDAC.

Citing Articles

Propensity Score Matching Analysis of the Safety of Completion Total Pancreatectomy for Remnant Pancreatic Tumors Versus that of Initial Total Pancreatectomy for Primary Pancreatic Tumors.

Kanemitsu E, Masui T, Nagai K, Anazawa T, Kasai Y, Yogo A Ann Surg Oncol. 2023; 30(7):4392-4406.

PMID: 36933081 DOI: 10.1245/s10434-023-13309-6.

Pancreatic Ductal Adenocarcinoma Concomitant with Main Duct Type Intraductal Papillary Mucinous Neoplasm of the Pancreas: A Case Report.

Yonamine K, Koshita S, Kanno Y, Ogawa T, Kusunose H, Sakai T Am J Case Rep. 2021; 22:e932565.

PMID: 34473678 PMC: 8422565. DOI: 10.12659/AJCR.932565.

Independent predictors of secondary invasive pancreatic remnant tumors after initial resection of an intraductal papillary mucinous neoplasm: a nationwide large-scale survey in Japan.

Takigawa Y, Kitago M, Matsui J Surg Today. 2020; 50(12):1672-1680.

PMID: 32661567 PMC: 7677271. DOI: 10.1007/s00595-020-02074-8.

References

Furukawa H, Okada S, Saisho H, Ariyama J, Karasawa E, Nakaizumi A . Clinicopathologic features of small pancreatic adenocarcinoma. A collective study. Cancer. 1996; 78(5):986-90. DOI: 10.1002/(SICI)1097-0142(19960901)78:5<986::AID-CNCR7>3.0.CO;2-A. View

Shimosegawa T, Kataoka K, Kamisawa T, Miyakawa H, Ohara H, Ito T . The revised Japanese clinical diagnostic criteria for chronic pancreatitis. J Gastroenterol. 2010; 45(6):584-91. DOI: 10.1007/s00535-010-0242-4. View

Muller M, Meyenberger C, Bertschinger P, Schaer R, Marincek B . Pancreatic tumors: evaluation with endoscopic US, CT, and MR imaging. Radiology. 1994; 190(3):745-51. DOI: 10.1148/radiology.190.3.8115622. View

Ingkakul T, Sadakari Y, Ienaga J, Satoh N, Takahata S, Tanaka M . Predictors of the presence of concomitant invasive ductal carcinoma in intraductal papillary mucinous neoplasm of the pancreas. Ann Surg. 2009; 251(1):70-5. DOI: 10.1097/SLA.0b013e3181c5ddc3. View

Yamaguchi K, Kanemitsu S, Hatori T, Maguchi H, Shimizu Y, Tada M . Pancreatic ductal adenocarcinoma derived from IPMN and pancreatic ductal adenocarcinoma concomitant with IPMN. Pancreas. 2011; 40(4):571-80. DOI: 10.1097/MPA.0b013e318215010c. View

Aso T, Ohtsuka T, Ideno N, Kono H, Nagayoshi Y, Mori Y . Diagnostic significance of a dilated orifice of the duodenal papilla in intraductal papillary mucinous neoplasm of the pancreas. Gastrointest Endosc. 2012; 76(2):313-20. DOI: 10.1016/j.gie.2012.03.682. View

Kanno A, Satoh K, Hirota M, Hamada S, Umino J, Itoh H . Prediction of invasive carcinoma in branch type intraductal papillary mucinous neoplasms of the pancreas. J Gastroenterol. 2010; 45(9):952-9. DOI: 10.1007/s00535-010-0238-0. View

Mohri D, Asaoka Y, Ijichi H, Miyabayashi K, Kudo Y, Seto M . Different subtypes of intraductal papillary mucinous neoplasm in the pancreas have distinct pathways to pancreatic cancer progression. J Gastroenterol. 2011; 47(2):203-13. DOI: 10.1007/s00535-011-0482-y. View

Yasuda K, Mukai H, Nakajima M, Kawai K . Staging of pancreatic carcinoma by endoscopic ultrasonography. Endoscopy. 1993; 25(2):151-5. DOI: 10.1055/s-2007-1010274. View

10.

Maguchi H, Tanno S, Mizuno N, Hanada K, Kobayashi G, Hatori T . Natural history of branch duct intraductal papillary mucinous neoplasms of the pancreas: a multicenter study in Japan. Pancreas. 2011; 40(3):364-70. DOI: 10.1097/MPA.0b013e31820a5975. View

11.

Yamaguchi K, Ohuchida J, Ohtsuka T, Nakano K, Tanaka M . Intraductal papillary-mucinous tumor of the pancreas concomitant with ductal carcinoma of the pancreas. Pancreatology. 2002; 2(5):484-90. DOI: 10.1159/000064716. View

12.

Tanno S, Nakano Y, Sugiyama Y, Nakamura K, Sasajima J, Koizumi K . Incidence of synchronous and metachronous pancreatic carcinoma in 168 patients with branch duct intraductal papillary mucinous neoplasm. Pancreatology. 2010; 10(2-3):173-8. DOI: 10.1159/000231982. View

13.

Ariyama J, Suyama M, Satoh K, Wakabayashi K . Endoscopic ultrasound and intraductal ultrasound in the diagnosis of small pancreatic tumors. Abdom Imaging. 1998; 23(4):380-6. DOI: 10.1007/s002619900365. View

14.

Tanaka M, Fernandez-Del Castillo C, Adsay V, Chari S, Falconi M, Jang J . International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012; 12(3):183-97. DOI: 10.1016/j.pan.2012.04.004. View

15.

Uehara H, Nakaizumi A, Ishikawa O, Iishi H, Tatsumi K, Takakura R . Development of ductal carcinoma of the pancreas during follow-up of branch duct intraductal papillary mucinous neoplasm of the pancreas. Gut. 2008; 57(11):1561-5. DOI: 10.1136/gut.2007.145631. View

16.

Yamaguchi K, Tanaka M . EBM-based Clinical Guidelines for Pancreatic Cancer 2009 from the Japan Pancreas Society: a synopsis. Jpn J Clin Oncol. 2011; 41(7):836-40. DOI: 10.1093/jjco/hyr077. View