A natural course of main duct intraductal papillary mucinous neoplasm of the pancreas with lower likelihood of malignancy.

Abstract:

OBJECTIVES:Main duct intraductal papillary mucinous neoplasms (IPMNs) of the pancreas include neoplasms with varying likelihood of progression to malignancy. The aim of this study was to investigate a natural course of main duct IPMNs with a lower likelihood of malignancy. METHODS:Twenty main duct IPMNs with a lower likelihood of malignancy, which was defined as mural nodule of less than 10 mm or no visualized mural nodule, and negative result of cytological examination of pancreatic juice, underwent regular ultrasound every 3 months. Special imaging examinations and additional pancreatic juice cytological examination were performed when necessary. Surgery was considered when a mural nodule enlarged to 10 mm or the cytological examination result indicated malignancy. RESULTS:During a mean of 70 months, 12 IPMNs (60%) did not progress and 6 (30%) progressed within a lower likelihood of malignancy. The remaining 2 IPMNs (10%) progressed to meet the criteria for resection, underwent surgery, and were demonstrated to be carcinomas. CONCLUSIONS:Main duct IPMN with a lower likelihood of malignancy was divided into 2 subgroups: neoplasm that progressed and that which did not progress during its natural course. The former should be resected considering its malignant potential, whereas the latter may be managed nonsurgically as long as it stays unchanged.

journal_name

Pancreas

journal_title

Pancreas

authors

Uehara H,Ishikawa O,Ikezawa K,Kawada N,Inoue T,Takakura R,Takano Y,Tanaka S,Takenaka A

doi

10.1097/MPA.0b013e3181c81b52

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

653-7

issue

5

eissn

0885-3177

issn

1536-4828

journal_volume

39

pub_type

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