Society of University SurgeonClinicopathologic features of re-resected cases of intraductal papillary mucinous neoplasms (IPMNs)
Section snippets
Methods
From October 1979 to September 2005 at the Department of Surgery, Nagoya University Hospital, 100 patients of IPMNs underwent operation. The medical records for these patients were retrospectively analyzed. Clinicopathologic features of 5 re-resected cases were also described.
The cystic lesion of the pancreas was identified either by ultrasonography (US), computed tomography (CT), or magnetic resonance imaging (MRI). The lesion was further examined by endoscopic retrograde pancreatography
Patients characteristics of 100 surgical cases
The average age was 62 ± 12 years. There were 65 males and 35 females. Thirty-one patients were main duct type, whereas 69 patients were branch duct type. The tumor was located in the head in 65 patients, body in 25 patients, and tail in 10 patients, respectively. The tumor located in the head most frequently and in the tail least frequently in both main duct and branch duct type (Fig 1).
Most patients with head tumors underwent pancreatoduodenectomy followed by a modified Child’s reconstruction
Discussion
IPMNs of the pancreas have relatively favorable prognosis as compared with that of invasive ductal carcinoma.5, 6, 7 Therefore, the follow-up period for IPMNs is longer than that of invasive ductal carcinoma. Despite the growing number of reports describing the surgical outcome of IPMNs, the natural history of this disease entity during long-period follow-up is still unclear. Because the clinicopathologic characteristics of IPMN are different from those of pancreatic invasive ductal carcinoma,
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American gastroenterological association technical review on the diagnosis and management of asymptomatic neoplastic pancreatic cysts
2015, GastroenterologyCitation Excerpt :The diagnosis of carcinoma in situ or HGD was not considered to be an invasive malignancy in this analysis; however, these studies were evaluated separately. We identified 111 studies involving 10,812 patients with IPMNs identified at surgery that reported on the presence or absence of invasive malignancy.35,37–39,60,63,70,76–179 There was significant heterogeneity between studies reporting on the rate of invasive malignancies in IPMNs (Cochran Q test = 626 [df = 110]; P < .0001; I2 = 82%; 95% CI, 79%–85%), with an overall invasive malignancy rate of 25% (95% CI, 23%–27%) using a random effects model.
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2008, Surgical Pathology of the GI Tract, Liver, Biliary Tract and Pancreas: Expert Consult - Online and PrintIntraductal Papillary Mucinous Neoplasms of the Pancreas: Indication, Extent, and Results of Surgery
2008, Surgical Oncology Clinics of North AmericaCitation Excerpt :Intrapancreatic recurrence occurs 1 to 11 years after initial resection, so follow-up should be prolonged [5,6,16,22]. Some of these recurrences occur in patients who had a tumor-free margin, thus proving that some IPMN are multifocal and discontinuous [5,22,24,81]. Diagnosis of discontinuous lesions is difficult; it can be done either preoperatively by peroral pancreatoscopy and intraductal endosonography [82] or intraoperatively by pancreatoscopy with staged biopsies [35] and intraductal cytology analyzed during the procedure [81].
Recurrence following Resection of Intraductal Papillary Mucinous Neoplasms: A Systematic Review to Guide Surveillance
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