Skip to main content

How to Follow Patients with Resected Cystic Tumors of the Pancreas

  • Chapter
  • First Online:
Cystic Tumors of the Pancreas

Abstract

Intraductal papillary mucinous neoplasm (IPMN) is a mucin-producing cystic lesion of the main pancreatic ducts and its branches. IPMNs were first uniquely described in the literature by Ohashi in 1982, who wrote of patients with pancreatic intraductal neoplasms with cystically dilated ducts containing large amounts of mucin [1]. However, it was not until 1996 that the World Health Organization (WHO) created separate diagnostic criteria to distinguish IPMNs from other cystic lesions of the pancreas [2]. Since that time, increasing focus has been shed on these lesions as precursors to pancreatic adenocarcinomas and, therefore, as a focus for early detection. Recent studies have shown that the risk of recurrence of IPMNs, even benign, is not insignificant. While criteria have been established for the surveillance and resection of IPMNs, very little is known about how to best follow patients who have undergone resection of an IPMN. Therefore, a thorough knowledge of the risk of malignancy and recurrence for IPMNs is needed for clinicians to properly follow these patients after surgical resection.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ohashi K, Murakami Y, Takekoshi T, et al. Four cases of mucin producing cancer of the pancreas on specific findings of the papilla of Vater. Prog Dig Endosc. 1982;20:348–51.

    Google Scholar 

  2. Kloppel G, Solcia E, Longnecker DS, et al. Histological typing of tumours of the exocrine pancreas. In: World health organization international classification of tumors. 2nd ed. Berlin: Springer; 1996. p. 11–20.

    Google Scholar 

  3. Bastid C, Bernard JP, Sarles H, et al. Mucinous ductal ectasia of the pancreas: a premalignant disease and a cause of obstructive pancreatitis. Pancreas. 1991;6:15–22.

    Article  CAS  PubMed  Google Scholar 

  4. Ferrari BT, O’Halloran RL, Longmire Jr WP, et al. Atypical papillary hyperplasia of the pancreatic duct mimicking obstructive pancreatic carcinoma. N Engl J Med. 1979;301:531–2.

    Article  CAS  PubMed  Google Scholar 

  5. Warshaw AL, Berry J, Gang DL. Villous adenoma of the duct of Wirsung. Dig Dis Sci. 1987;32(11):1311–3.

    Article  CAS  PubMed  Google Scholar 

  6. Yamada M, Kozuka S, Yamao K, et al. Mucin-producing tumor of the pancreas. Cancer. 1991;68(1):159–68.

    Article  CAS  PubMed  Google Scholar 

  7. Morohoshi T, Kanda M, Asanuma K, et al. Intraductal papillary neoplasms of the pancreas: a clinicopathologic study of six patients. Cancer. 1989;64(6):1329–35.

    Article  CAS  PubMed  Google Scholar 

  8. Sessa F, Solcia E, Capella C, et al. Intraductal papillary-mucinous tumours represent a distinct group of pancreatic neoplasms: an investigation of tumour cell differentiation and K-ras, p53, and c-erbB-2 abnormalities in 26 patients. Virchows Arch. 1994;425:357–67.

    Article  CAS  PubMed  Google Scholar 

  9. Tanaka M, Chari S, Adsay V, et al. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Pancreatology. 2006;6:17–32.

    Article  PubMed  Google Scholar 

  10. Tanaka M, Fernandez-del Castillo C, Adsay V, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012;12:183–97.

    Article  PubMed  Google Scholar 

  11. Grutzmann R, Niedergethmann M, Pilarsky C, et al. Intraductal papillary mucinous tumors of the pancreas: biology, diagnosis, and treatment. Oncologist. 2010;15(12):1294.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Shi C, Hruban RH. Intraductal papillary mucinous neoplasm. Hum Pathol. 2012;43:1–16.

    Article  PubMed  Google Scholar 

  13. Schnelldorfer T, Sarr MG, Nagorney DM, et al. Experience with 208 resections for intraductal papillary mucinous neoplasm of the pancreas. Arch Surg. 2008;143(7):639–46.

    Article  PubMed  Google Scholar 

  14. Chari ST, Yadav D, Smyrk TC, et al. Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas. Gastroenterology. 2002;123:1500–7.

    Article  PubMed  Google Scholar 

  15. Hwang DW, Jang JY, Lee SE, et al. Clinicopathologic analysis of surgically proven intraductal papillary mucinous neoplasms of the pancreas in SNUH: a 15-year experience at a single academic institution. Langenbecks Arch Surg. 2010;397:93–102.

    Article  PubMed  Google Scholar 

  16. Lubezky N, Ben-Haim M, Nakache R, et al. Clinical presentation can predict disease course in patients with intraductal papillary mucinous neoplasm of the pancreas. World J Surg. 2010;34:126–32.

    Article  PubMed  Google Scholar 

  17. Laffan TA, Horton KM, Klein AP, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol. 2008;191:802–7.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Winter JM, Cameron JL, Lillemoe KD, et al. Periampullary and pancreatic incidentaloma: a single institution’s experience with an increasingly common diagnosis. Ann Surg. 2006;243(5):673–83.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Fernandez-del Castillo C, Targorona J, Thayer SP, et al. Incidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients. Arch Surg. 2003;138(4):427–34.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Hruban RH, Takaori K, Klimstra DS, et al. An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms. Am J Surg Pathol. 2004;28(8):977–87.

    Article  PubMed  Google Scholar 

  21. Kim SC, Park KT, Lee YJ, Lee SS, et al. Intraductal papillary mucinous neoplasm of the pancreas: clinical characteristics and treatment outcomes in 118 consecutive patients from a single center. J Hepatobiliary Pancreat Surg. 2008;15:183–8.

    Article  PubMed  Google Scholar 

  22. Nara S, Onaya H, Hiraoka N, Shimada K, et al. Preoperative evaluation of invasive and noninvasive intraductal papillary mucinous neoplasms of the pancreas: clinical, radiological, and pathological analysis of 123 cases. Pancreas. 2009;38:8–16.

    Article  PubMed  Google Scholar 

  23. Nagai K, Doi R, Kida A, Kami K, et al. Intraductal papillary mucinous neoplasms of the pancreas: clinicopathologic characteristics and long-term follow-up after resection. World J Surg. 2008;32:271–8.

    Article  PubMed  Google Scholar 

  24. Lee SY, Lee KT, Lee JK, Jeon YH, et al. Long-term follow up results of intraductal papillary mucinous tumors of the pancreas. J Gastroenterol Hepatol. 2005;20:1379–84.

    Article  PubMed  Google Scholar 

  25. Sadakari Y, Ienaga J, Kobayashi K, Miyasaka Y, et al. Cyst size indicates malignant transformation in branch duct intraductal papillary mucinous neoplasm of the pancreas without mural nodules. Pancreas. 2010;39:232–6.

    Article  PubMed  Google Scholar 

  26. Bournet B, Kirzin S, Carrere N, Portier G, et al. Clinical fate of branch duct and mixed forms of intraductal papillary mucinous neoplasia of the pancreas. J Gastroenterol Hepatol. 2009;24:1211–7.

    Article  PubMed  Google Scholar 

  27. Salvia R, Fernandez-del Castillo C, Bassi C, et al. Main-duct intraductal papillary mucinous neoplasms of the pancreas: clinical predictors of malignancy and long-term survival following resection. Ann Surg. 2004;239(5):678–85.

    Article  PubMed  PubMed Central  Google Scholar 

  28. White R, D’Angelica M, Katabi N, et al. Fate of the remnant pancreas after resection of noninvasive intraductal papillary mucinous neoplasm. J Am Coll Surg. 2007;204:987–95.

    Article  PubMed  Google Scholar 

  29. Miller JR, Meyer JE, Waters JA, et al. Outcome of the pancreatic remnant following segmental pancreatectomy for non-invasive intraductal papillary mucinous neoplasm. HPB. 2011;13(11):759–66.

    Article  PubMed  PubMed Central  Google Scholar 

  30. He J, Cameron JL, Ahuja N, Makary MA, et al. Is it necessary to follow patients after resection of a benign pancreatic intraductal papillary mucinous neoplasm? J Am Coll Surg. 2013;216:657–67.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Tanno S, Nakano Y, Koizumi K, et al. Pancreatic ductal adenocarcinomas in long-term follow-up patients with branch duct intraductal papillary mucinous neoplasms. Pancreas. 2010;39(1):36–40.

    Article  PubMed  Google Scholar 

  32. Tamura K, Ohtsuka T, Ideno N, et al. Unresectable pancreatic ductal adenocarcinoma in the remnant pancreas diagnosed during every 6-month surveillance after resection of branch duct intraductal papillary mucinous neoplasm: a case report. JOP. 2013;14(4):450–3.

    PubMed  Google Scholar 

  33. Ohtsuka T, Kono H, Tanabe R, et al. Follow-up study after resection of intraductal papillary mucinous neoplasm of the pancreas: special references to the multifocal lesions and development of ductal carcinoma in the remnant pancreas. Am J Surg. 2012;204(1):44–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Katherine E. Poruk MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Poruk, K.E., Wolfgang, C.L. (2016). How to Follow Patients with Resected Cystic Tumors of the Pancreas. In: Del Chiaro, M., Haas, S., Schulick, R. (eds) Cystic Tumors of the Pancreas. Springer, Cham. https://doi.org/10.1007/978-3-319-31882-0_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-31882-0_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31880-6

  • Online ISBN: 978-3-319-31882-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics