Intraductal Papillary Mucinous Neoplasm of the Pancreas: An Update

Intraductal papillary mucinous neoplasm (IPMN) is a cystic tumor of the pancreas. The etiology is unknown, but increasing evidence suggests the involvement of several tumorigenesis pathways, including an association with hereditary syndromes. IPMN occurs more commonly in men, with the mean age at...

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1. autor: Shu-Yuan Xiao
Format: Artykuł
Język:English
Wydane: Hindawi Limited 2012-01-01
Seria:Scientifica
Dostęp online:http://dx.doi.org/10.6064/2012/893632
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author Shu-Yuan Xiao
author_facet Shu-Yuan Xiao
author_sort Shu-Yuan Xiao
collection DOAJ
description Intraductal papillary mucinous neoplasm (IPMN) is a cystic tumor of the pancreas. The etiology is unknown, but increasing evidence suggests the involvement of several tumorigenesis pathways, including an association with hereditary syndromes. IPMN occurs more commonly in men, with the mean age at diagnosis between 64 and 67 years old. At the time of diagnosis, it may be benign, with or without dysplasia, or frankly malignant with an invasive carcinoma. Tumors arising from the main pancreatic duct are termed main-duct IPMNs, those involving the branch ducts, branch-duct IPMNs. In general, small branch-duct IPMNs are benign, particularly in asymptomatic patients, and can be safely followed. In contrast, main-duct tumors should be surgically resected and examined carefully for an invasive component. In the absence of invasion, patient’s survival is excellent, from 94 to 100%. For patients with an IPMN-associated invasive carcinoma, the prognosis overall is better than those with a de novo pancreatic ductal adenocarcinoma, with a 5-year survival of 40% to 60% in some series. However, no survival advantage can be demonstrated if the invasive component in an IPMN patient is that of the conventional tubular type (versus mucinous carcinoma). Several histomorphologic variants are recognized, although the clinical significance of this “subtyping” is not well defined.
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spelling doaj.art-dbd984fb908a43e7a4051b49557b3bf82024-10-03T05:36:06ZengHindawi LimitedScientifica2090-908X2012-01-01201210.6064/2012/893632893632Intraductal Papillary Mucinous Neoplasm of the Pancreas: An UpdateShu-Yuan Xiao0Department of Pathology, University of Chicago Medical Center, 5841 South Maryland Avenue, MC6101, Chicago, IL 60637, USAIntraductal papillary mucinous neoplasm (IPMN) is a cystic tumor of the pancreas. The etiology is unknown, but increasing evidence suggests the involvement of several tumorigenesis pathways, including an association with hereditary syndromes. IPMN occurs more commonly in men, with the mean age at diagnosis between 64 and 67 years old. At the time of diagnosis, it may be benign, with or without dysplasia, or frankly malignant with an invasive carcinoma. Tumors arising from the main pancreatic duct are termed main-duct IPMNs, those involving the branch ducts, branch-duct IPMNs. In general, small branch-duct IPMNs are benign, particularly in asymptomatic patients, and can be safely followed. In contrast, main-duct tumors should be surgically resected and examined carefully for an invasive component. In the absence of invasion, patient’s survival is excellent, from 94 to 100%. For patients with an IPMN-associated invasive carcinoma, the prognosis overall is better than those with a de novo pancreatic ductal adenocarcinoma, with a 5-year survival of 40% to 60% in some series. However, no survival advantage can be demonstrated if the invasive component in an IPMN patient is that of the conventional tubular type (versus mucinous carcinoma). Several histomorphologic variants are recognized, although the clinical significance of this “subtyping” is not well defined.http://dx.doi.org/10.6064/2012/893632
spellingShingle Shu-Yuan Xiao
Intraductal Papillary Mucinous Neoplasm of the Pancreas: An Update
Scientifica
title Intraductal Papillary Mucinous Neoplasm of the Pancreas: An Update
title_full Intraductal Papillary Mucinous Neoplasm of the Pancreas: An Update
title_fullStr Intraductal Papillary Mucinous Neoplasm of the Pancreas: An Update
title_full_unstemmed Intraductal Papillary Mucinous Neoplasm of the Pancreas: An Update
title_short Intraductal Papillary Mucinous Neoplasm of the Pancreas: An Update
title_sort intraductal papillary mucinous neoplasm of the pancreas an update
url http://dx.doi.org/10.6064/2012/893632
work_keys_str_mv AT shuyuanxiao intraductalpapillarymucinousneoplasmofthepancreasanupdate