Intraductal papillary mucinous neoplasm
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|Intraductal papillary mucinous neoplasm|
|Intraductal papillary mucinous neoplasm in magnetic resonance imaging.|
|Classification and external resources|
Intraductal papillary mucinous neoplasm (IPMN) is a type of tumor that can occur within the cells of the pancreatic duct. IPMN tumors produce mucus, and this mucus can form pancreatic cysts. Although intraductal papillary mucinous neoplasms are benign tumors, they can progress to pancreatic cancer. As such IPMN is viewed as a precancerous condition. Once an intraductal papillary mucinous neoplasm has been found, the management options include close monitoring and pre-emptive surgery.[medical citation needed]
The treatment of choice for main-duct IPMNs is resection due to approximately 50% chance of malignancy. Side-branch IPMNs are occasionally monitored with regular CT or MRIs, but most are eventually resected, with a 30% rate of malignancy in these resected tumors. Survival 5 years after resection of an IPMN without malignancy is approximately 80%, 85% with malignancy but no lymph node spread and 0% with malignancy spreading to lymph nodes. Surgery can include the removal of the head of the pancreas (a pancreaticoduodenectomy), removal of the body and tail of the pancreas (a distal pancreatectomy), or rarely removal of the entire pancreas (a total pancreatectomy). In selected cases the surgery can be performed using minimally invasive techniques such as laparoscopy or robotic surgery. A study using Surveillance, Epidemiology, and End Result Registry (SEER) data suggested that increased lymph node counts harvested during the surgery were associated with better survival in invasive IPMN patients.
In 1982, IPMN was reported as a "mucin-producing tumor" by Kazuhiko Ohashi of the Japanese Foundation for Cancer Research.
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- Campbell, NM; Katz, SS; Escalon, JG; Do, RK (March 2015). "Imaging patterns of intraductal papillary mucinous neoplasms of the pancreas: an illustrated discussion of the International Consensus Guidelines for the Management of IPMN". Abdominal Imaging. 40 (3): 663–77. doi:10.1007/s00261-014-0236-4. PMID 25219664.
- "Precancerous conditions of the pancreas - Canadian Cancer Society". www.cancer.ca. Retrieved 5 November 2017.
- Sohn, Taylor (June 2004). "Intraductal Papillary Mucinous Neoplasms of the Pancreas". Annals of Surgery. 239 (6): 788–799. doi:10.1097/01.sla.0000128306.90650.aa. PMC . PMID 15166958.
- "Pancreatic Surgery". Johns Hopkins University. Retrieved 7 September 2009.
- "Laproscopic Pancreatic Surgery". Johns Hopkins University. Retrieved 7 September 2009.
- Wu, WM (Sep 2014). "An increased total resected lymph node count benefits survival following pancreas invasive intraductal papillary mucinous neoplasms resection: an analysis using the surveillance, epidemiology, and end result registry database". PLOS ONE. 9 (9): e107962. doi:10.1371/journal.pone.0107962. PMC . PMID 25264746.