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KMID : 0882420070720030272
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Korean Journal of Medicine
2007 Volume.72 No. 3 p.272 ~ p.280
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Clinicopathological features of intraductal papillary mucinous neoplasms of the pancreas: an emphasis on predictors of malignancy.
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Yoon Won-Jae
Lee Jun-Kyu
Park Joo-Kyung
Lee Sang-Hyub
Ryu Ji-Kon
Kim Yong-Tae
Yoon Yong-Bum
Jang Jin-Young
Kim Sun-Whe
Kim Woo-Ho
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Abstract
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Background: Intraductal papillary mucinous neoplasm of the pancrea (IPMN) is a newly recognized category of pancreatic exocrine tumors with a favorable prognosis. We conducted this study to evaluate clinicopathological features of IPMNs and to evaluate clinical factors associated with malignant IPMNs.
Methods: We retrospectively evaluated 91 patients (55 males, mean age 61.6 years) who were diagnosed with IPMNs with histological confirmation from 1993 to 2004.
Results: Fifty-eight cases were incidentally found, whereas 33 cases were symptomatic. Pathology revealed adenoma in 19 cases, IPMN with moderate dysplasia in 50 cases, noninvasive carcinoma in 8 cases, and invasive carcinoma in 14 cases. In main duct type (n=13) and combined type IPMNs (n=5), visible mucin secretion as seen on endoscopy indicated a borderline association with malignancy; a large tumor diameter (> or =30 mm) was associated with malignancy. In branch duct type IPMNs (n=73), the presence of symptoms or signs, the presence of mural nodules, a large tumor diameter (> or =27 mm) and a larger main pancreatic duct diameter (> or =4 mm) were associated with malignancy.
Conclusion: In IPMNs involving the main pancreatic duct, a large tumor diameter (> or =30 mm) is associated with malignancy. In branch duct type IPMNs, the presence of symptoms or signs, the presence of mural nodules, a large tumor diameter (> or =27 mm) and a large main pancreatic duct diameter (> or =4 mm) are associated with malignancy.
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KEYWORD
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Pancreas, Neoplasms
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