Document Detail

Intraductal papillary mucinous neoplasia (IPMN) of the pancreas: its diagnosis, treatment, and prognosis.
MedLine Citation:
PMID:  22163260     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The many varieties of cystic pancreatic tumor, and especially intraductal papillary mucinous neoplasia (IPMN), have attracted increased attention recently. Their incidence may be rising, and their histopathological evaluation and classification have become more precise than before.
METHODS: We discuss the current diagnostic evaluation of IPMN, along with treatment and prognostication, on the basis of the current international guideline as well as pertinent literature retrieved by a selective PubMed search.
RESULTS: The preoperative diagnostic evaluation of IPMN is often problematic. In particular, it may not be possible to differentiate main-duct disease from branch-duct disease (MD-IPMN vs. BD-IPMN) before surgery--a distinction with implications for prognosis and treatment, as MD-IPMN is more often malignant. An IPMN adenoma can develop into invasive pancreatic cancer. Because firm diagnostic criteria are still lacking, it is recommended that all MD-IPMN lesions and all large BD-IPMN lesions should be resected. Partial pancreatectomy with clean margins is the treatment of choice.
CONCLUSION: As IPMN seems to be a slow-growing precursor of pancreatic cancer, it is possible that its early detection and surgical treatment can lead to a cure. No conclusion about the efficacy of surveillance and follow-up programs can be drawn from the available evidence. A better understanding of the natural course of IPMN and the biology of pancreatic cancer is needed to enable further improvements in diagnosis and treatment.
Robert Grützmann; Stefan Post; Hans Detlev Saeger; Marco Niedergethmann
Publication Detail:
Type:  Journal Article; Review     Date:  2011-11-18
Journal Detail:
Title:  Deutsches Ärzteblatt international     Volume:  108     ISSN:  1866-0452     ISO Abbreviation:  Dtsch Arztebl Int     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-12-13     Completed Date:  2012-04-17     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  101475967     Medline TA:  Dtsch Arztebl Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  788-94     Citation Subset:  IM    
Chirurgische Klinik, Universitätsmedizin Mannheim, Med. Fakultät Mannheim, Mannheim, Germany.
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MeSH Terms
Adenocarcinoma, Mucinous / diagnosis*,  surgery*
Pancreatectomy / methods*
Pancreatic Neoplasms / diagnosis*,  surgery*
Papilloma, Intraductal / diagnosis*,  surgery*
Treatment Outcome

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