Early Cancerous Lesions of the Pancreas and Ampulla: Current Concepts and Challenges

Overview

Journal Gastroenterol Clin North Am

Specialty Gastroenterology

Date 2024 Jan 27

PMID 38280751

Authors

Olca Basturk

N Volkan Adsay

Affiliations

Soon will be listed here.

Abstract

Owing to the increased use of advanced imaging techniques, mass-forming (cystic/intraductal) preinvasive neoplasms are being detected much more frequently and they have rapidly become one of the main focuses of interests in medical field. These neoplasms have very distinctive clinical and radiographic findings, exhibit a spectrum of dysplastic transformation, from low-grade dysplasia to high-grade dysplasia, and may be associated with an invasive carcinoma. Accounting for about 5% to 10% of pancreatic ductal adenocarcinomas, they provide a curable target subset in an otherwise biologically dismal pancreas cancer category.

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References

Domizio P, Talbot I, Spigelman A, Williams C, Phillips R . Upper gastrointestinal pathology in familial adenomatous polyposis: results from a prospective study of 102 patients. J Clin Pathol. 1990; 43(9):738-43. PMC: 502752. DOI: 10.1136/jcp.43.9.738. View

Zhelnin K, Xue Y, Quigley B, Reid M, Choi H, Memis B . Nonmucinous Biliary Epithelium Is a Frequent Finding and Is Often the Predominant Epithelial Type in Mucinous Cystic Neoplasms of the Pancreas and Liver. Am J Surg Pathol. 2016; 41(1):116-120. DOI: 10.1097/PAS.0000000000000745. View

Klein W, Hruban R, Klein-Szanto A, Wilentz R . Direct correlation between proliferative activity and dysplasia in pancreatic intraepithelial neoplasia (PanIN): additional evidence for a recently proposed model of progression. Mod Pathol. 2002; 15(4):441-7. DOI: 10.1038/modpathol.3880544. View

Adsay V, Jang K, Roa J, Dursun N, Ohike N, Bagci P . Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder (neoplastic polyps, adenomas, and papillary neoplasms that are ≥1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases. Am J Surg Pathol. 2012; 36(9):1279-301. DOI: 10.1097/PAS.0b013e318262787c. View

Muraki T, Reid M, Basturk O, Jang K, Bedolla G, Bagci P . Undifferentiated Carcinoma With Osteoclastic Giant Cells of the Pancreas: Clinicopathologic Analysis of 38 Cases Highlights a More Protracted Clinical Course Than Currently Appreciated. Am J Surg Pathol. 2016; 40(9):1203-16. PMC: 4987218. DOI: 10.1097/PAS.0000000000000689. View

Brat D, Lillemoe K, Yeo C, Warfield P, Hruban R . Progression of pancreatic intraductal neoplasias to infiltrating adenocarcinoma of the pancreas. Am J Surg Pathol. 1998; 22(2):163-9. DOI: 10.1097/00000478-199802000-00003. View

Iacobuzio-Donahue C, Klimstra D, Adsay N, Wilentz R, Argani P, Sohn T . Dpc-4 protein is expressed in virtually all human intraductal papillary mucinous neoplasms of the pancreas: comparison with conventional ductal adenocarcinomas. Am J Pathol. 2000; 157(3):755-61. PMC: 1885701. DOI: 10.1016/S0002-9440(10)64589-0. View

Tanaka M, Fernandez-Del Castillo C, Kamisawa T, Jang J, Levy P, Ohtsuka T . Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 2017; 17(5):738-753. DOI: 10.1016/j.pan.2017.07.007. View

Adsay V, Mino-Kenudson M, Furukawa T, Basturk O, Zamboni G, Marchegiani G . Pathologic Evaluation and Reporting of Intraductal Papillary Mucinous Neoplasms of the Pancreas and Other Tumoral Intraepithelial Neoplasms of Pancreatobiliary Tract: Recommendations of Verona Consensus Meeting. Ann Surg. 2015; 263(1):162-77. PMC: 4568174. DOI: 10.1097/SLA.0000000000001173. View

10.

Noda Y, Watanabe H, Iida M, Narisawa R, Kurosaki I, IWAFUCHI M . Histologic follow-up of ampullary adenomas in patients with familial adenomatosis coli. Cancer. 1992; 70(7):1847-56. DOI: 10.1002/1097-0142(19921001)70:7<1847::aid-cncr2820700707>3.0.co;2-c. View

11.

Andea A, Sarkar F, Adsay V . Clinicopathological correlates of pancreatic intraepithelial neoplasia: a comparative analysis of 82 cases with and 152 cases without pancreatic ductal adenocarcinoma. Mod Pathol. 2003; 16(10):996-1006. DOI: 10.1097/01.MP.0000087422.24733.62. View

12.

Xue Y, Reid M, Balci S, Quigley B, Muraki T, Memis B . Immunohistochemical Classification of Ampullary Carcinomas: Critical Reappraisal Fails to Confirm Prognostic Relevance for Recently Proposed Panels, and Highlights MUC5AC as a Strong Prognosticator. Am J Surg Pathol. 2017; 41(7):865-876. DOI: 10.1097/PAS.0000000000000863. View

13.

Adsay N, Adair C, Heffess C, Klimstra D . Intraductal oncocytic papillary neoplasms of the pancreas. Am J Surg Pathol. 1996; 20(8):980-94. DOI: 10.1097/00000478-199608000-00007. View

14.

Lucocq J, Hawkyard J, Robertson F, Haugk B, Lye J, Parkinson D . Risk of Recurrence After Surgical Resection for Adenocarcinoma Arising From Intraductal Papillary Mucinous Neoplasia (IPMN) With Patterns of Distribution and Treatment: An International, Multicenter, Observational Study (ADENO-IPMN Study). Ann Surg. 2023; 280(1):126-135. DOI: 10.1097/SLA.0000000000006144. View

15.

Basturk O, Adsay V, Askan G, Dhall D, Zamboni G, Shimizu M . Intraductal Tubulopapillary Neoplasm of the Pancreas: A Clinicopathologic and Immunohistochemical Analysis of 33 Cases. Am J Surg Pathol. 2016; 41(3):313-325. PMC: 5309137. DOI: 10.1097/PAS.0000000000000782. View

16.

Springer S, Masica D, Dal Molin M, Douville C, Thoburn C, Afsari B . A multimodality test to guide the management of patients with a pancreatic cyst. Sci Transl Med. 2019; 11(501). PMC: 7859881. DOI: 10.1126/scitranslmed.aav4772. View

17.

Hirono S, Shimizu Y, Ohtsuka T, Kin T, Hara K, Kanno A . Recurrence patterns after surgical resection of intraductal papillary mucinous neoplasm (IPMN) of the pancreas; a multicenter, retrospective study of 1074 IPMN patients by the Japan Pancreas Society. J Gastroenterol. 2019; 55(1):86-99. DOI: 10.1007/s00535-019-01617-2. View

18.

Irie H, Yoshimitsu K, Aibe H, Tajima T, Nishie A, Nakayama T . Natural history of pancreatic intraductal papillary mucinous tumor of branch duct type: follow-up study by magnetic resonance cholangiopancreatography. J Comput Assist Tomogr. 2004; 28(1):117-22. DOI: 10.1097/00004728-200401000-00020. View

19.

Rosenberg J, Welch J, PYRTEK L, Walker M, Trowbridge P . Benign villous adenomas of the ampulla of Vater. Cancer. 1986; 58(7):1563-8. DOI: 10.1002/1097-0142(19861001)58:7<1563::aid-cncr2820580730>3.0.co;2-e. View

20.

Azar C, Van de Stadt J, Rickaert F, Deviere M, Baize M, Kloppel G . Intraductal papillary mucinous tumours of the pancreas. Clinical and therapeutic issues in 32 patients. Gut. 1996; 39(3):457-64. PMC: 1383356. DOI: 10.1136/gut.39.3.457. View