Intraductal papillary mucinous neoplasm: Did it exist prior to 1980?

Introduction Intraductal papillary mucinous neoplasm (IPMN) of the pancreas was first reported in 1982. It is not clear whether the appearance of this neoplasm is a new epidemic or an old disease previously overlooked. Aim To determine whether IPMN existed as a separate entity before 1982. Methodology We reviewed our pathology reports from all cases of pancreatic cancer diagnosed between 1960 and 1980. Pathologic specimens with descriptors—“mucinous,” “cystic,” or “papillary”—underwent histologic reexamination. Medical records for patients given a new diagnosis of IPMN from this pathologic review were assessed. Results Eighty-four of more than 4,000 pathology reports reviewed contained a key word triggering histologic review. IPMN was identified in 21 patients. Patients had a mean age of 63 years (range, 44-77 years) with symptoms present for a mean of 76 months (median, 15 months; range, 1-516 months). Reported symptoms were abdominal pain in 17, jaundice in 13, weight loss in 12, and pancreatic insufficiency in 7 patients. On pathologic review, the in situ component was graded as adenoma in 4, borderline in 4, and carcinoma in 13. Parenchymal invasion was present in 11/21 (52%). Excluding four postoperative mortalities, mean time to death was 58 months (median, 15 months; range, 2-264 months). Seven patients died of IPMN, 4 of other causes without evidence of recurrence, and 6 of unknown causes. Conclusions IPMN existed in its current known form prior to 1982. Our study cannot determine whether the prevalence or incidence has changed since that time.