Primary pancreatic cystic neoplasms revisited. Part III. Intraductal papillary mucinous neoplasms

George H. Sakorafas, Vasileios Smyrniotis, Kaye M. Reid-Lombardo, Michael G. Sarr

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Intraductal papillary mucinous neoplasms (IPMNs) represent about 25% of all primary pancreatic cystic neoplasms and are increasingly recognized during the last two decades. They are characterized by intraductal proliferation of neoplastic mucinous cells forming papillary projections into the pancreatic ductal system, which is typically dilated and contains globules of mucus. IPMNs may be multifocal and have malignant potential. Modern imaging is essential in establishing preoperative diagnosis and in differentiating different subtypes of IPMNs (i.e., main-duct vs. branch-type disease). Endoscopic retrograde or magnetic resonance cholangiopancreatography accurately delineate the morphologic changes of the pancreatic ductal system. Endoscopic ultrasonography (usually used in conjunction with imageguided FNA and analysis of the aspirated material) is commonly used for differential diagnosis of IPMNs from other pancreatic cystic lesions. Surgical resection (usually anatomic pancreatectomy, depending on the location of the disease) is the treatment of choice. Total pancreatectomy may occasionally be required in selected patients, but is associated with formidable long-term morbidity. A conservative approach has recently been proposed for carefully selected patients with branch-duct IPMNs. Recurrences following surgical resection can be observed, especially in patients with multifocal disease or in the presence of underlying malignancy.

Original languageEnglish (US)
JournalSurgical Oncology
Volume20
Issue number2
DOIs
StatePublished - Jun 2011

Fingerprint

Pancreatic Neoplasms
Pancreatectomy
Neoplasms
Magnetic Resonance Cholangiopancreatography
Endosonography
Mucus
Differential Diagnosis
Morbidity
Recurrence
Therapeutics

Keywords

  • Cystic neoplasms
  • IPMN
  • Pancreas
  • Pancreatectomy
  • Surgery
  • Tumors

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Primary pancreatic cystic neoplasms revisited. Part III. Intraductal papillary mucinous neoplasms. / Sakorafas, George H.; Smyrniotis, Vasileios; Reid-Lombardo, Kaye M.; Sarr, Michael G.

In: Surgical Oncology, Vol. 20, No. 2, 06.2011.

Research output: Contribution to journalArticle

Sakorafas, George H. ; Smyrniotis, Vasileios ; Reid-Lombardo, Kaye M. ; Sarr, Michael G. / Primary pancreatic cystic neoplasms revisited. Part III. Intraductal papillary mucinous neoplasms. In: Surgical Oncology. 2011 ; Vol. 20, No. 2.
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