Purpose: To determine the frequency of intraductal papillary mucinous neoplasm (IPMN) in patients with and without invasive ductal adenocarcinoma (IDAC). Methods: 82 patients underwent pancreatectomy for pancreas adenocarcinoma. 68/82 subjects underwent at least one preoperative imaging study including CT (n = 43), MRI (n = 25), or both (n = 12). Imaging studies were retrospectively evaluated to determine if IPMN was present in the gland at a location distant from IDAC. In 183 different adult patients undergoing MRI for renal mass, images were evaluated to determine the frequency of IPMN. Fisher’s exact test was used to test whether the prevalence of IPMN was greater among patients with pancreas cancer than those without. Results: Five of 68 (7.3%) patients who underwent pancreatic resection for IDAC had IPMN at a site distant from the cancer. Two of 182 (1.1%) patients undergoing MRI for renal cancer had imaging evidence of IPMN. There was a significant difference (p = 0.017) in the prevalence of IPMN between patients with and without IDAC. The odds ratio for IPMN as a predictor of pancreas cancer was estimated as 7.18. Conclusion: IPMN occurs with increased frequency in patients with pancreas cancer as opposed to those without pancreas cancer.

Keywords:
Intraductal papillary mucinous neoplasm, Invasive ductal adenocarcinoma, Mucinous cystic tumor, Pancreas cancer, Pancreatic adenocarcinoma, Pancreatic intraepithelial neoplasia
1.
Jemal A, Siegel R, Ward E, et al: Cancer statistics 2006. CA Cancer J Clin 2006;56:106–130.
2.
Hruban RH, Maitra A, Kern SE, Goggins M: Precursors to pancreatic cancer. Gastroenterol Clin N Am 2007;36:831–849.
3.
Sahani DV, Kadavigere R, Blake M, et al: Intraductal papillary mucinous neoplasm of pancreas: multi-detector row CT with 2D curved reformations – correlation with MRCP. Radiology 2006;238:560–569.
4.
Kim SY, Lee JM, Kim SH, et al: Macrocystic neoplasms of the pancreas: CT differentiation of serous oligocystic adenoma from mucinous cystadenoma and intraductal papillary mucinous tumor. AJR Am J Roentgenol 2006;187:1192–1198.
5.
Allen PJ, D’Angellica M, Gonen M, et al: A selective approach to the resection of cystic pancreatic lesions of the pancreas. Results from 539 consecutive patients. Ann Surg 2006;244:572–582.
6.
Khalid A, Brugge W: ACG practice guidelines for the diagnosis and management of neoplastic pancreatic cysts. Am J Gastroenterol 2007;102:2339–2349.
7.
Procacci C, Graziani R, Bicego E, et al. Intraductal mucin producing tumors of the pancreas: imaging findings. Radiology 1996;198:249–257.
8.
Suigiyama M, Suzuki Y, Abe N, et al: Management of intraductal papillary mucinous neoplasm of the pancreas. J Gastroenterol 2008;43:181–185.
9.
Sohn TA, Yeo CJ, Caneron JL, et al: Intraductal papillary mucinous neoplasms of the pancreas: an increasingly recognized clinicopathologic entity. Ann Surg 2001;234:313–322.
10.
Uehara H, Nakaizumi A, Ishikawa O, et al: Development of ductal carcinoma of the pancreas during follow-up of branch duct intraductal papillary mucinous neoplasm of the pancreas. Gut 2008;57:1561–1565.
11.
Moriya T, Kimura W, Sakurai F, et al: Minute invasive ductal carcinoma of the residual pancreas after distal pancreatectomy for intraductal papillary-mucinous neoplasm. Int J Gastrointest Cancer 2002;31:191–197.
12.
Yamaguchi K, Ohuchida J, Ohtsuka T, Nakano K: Intraductal papillary-mucinous tumor of the pancreas concomitant with ductal carcinoma of the pancreas. Pancreatology 2002;2:484–490.
13.
Katabi N, Klimstra DS: Intraductal papillary mucinous neoplasm of the pancreas: clinical and pathological features and diagnostic approach. J Clin Pathol 2008;61:1303–1313.
14.
Tada M, Kawabe T, Arizumi, et al: Pancreatic cancer in patients with pancreatic cystic lesions: a prospective study of 197 patients. Clin Gastroentrol Hepatol 2006;4:1265–1270.
15.
Salvia R, Crippa S, Falconi M, et al: Branch-duct intraductal papillary mucinous neoplasm of the pancreas: to operate or not to operate? Gut 2007;56:1086–1090.
16.
Weitz J, Büchler MW: Branch intraductal papillary mucinous neoplasms: just the tip of the iceberg. Gut 2008;57:1490–1491.
17.
Biankin AV, Kench JG, Biankin SA, et al: Pancreatic intraepithelial neoplasia in association with intraductal papillary mucinous neoplasms of the pancreas. Am J Surg Pathol 2004;28:1184–1192.
18.
Laffan TA, Horton KM, Klein AP, et al: Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol 2008:191:802–807.
19.
Zhang XM, Mitchell DG, Doske M, et al: Pancreatic cysts: depiction on single-shot fast-spin echo MR images. Radiology 2002;223:547–553.
20.
Kimura W, Nagai H, Kuroda A, et al: Analysis of small cystic lesions of the pancreas. Int J Pancreatol 1995;18:197–206.
© 2011 S. Karger AG, Basel and IAP
2011
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.