Clinical Gastroenterology Vol.24 No.9(7)

Theme Intraductal Papillary Mucinous Neoplasm (IPMN)
Title Natural History of Intraductal Papillary Mucinous Neoplasms
Publish Date 2009/08
Author Mitsuharu Fukasawa Center for Gastroenterology, Teine Keijinkai Hospital
Author Hiroyuki Maguchi Center for Gastroenterology, Teine Keijinkai Hospital
Author Kuniyuki Takahashi Center for Gastroenterology, Teine Keijinkai Hospital
Author Akio Katanuma Center for Gastroenterology, Teine Keijinkai Hospital
Author Manabu Osanai Center for Gastroenterology, Teine Keijinkai Hospital
Author Tamaki Ichiya Center for Gastroenterology, Teine Keijinkai Hospital
Author Akira Kurita Center for Gastroenterology, Teine Keijinkai Hospital
Author Toshifumi Kin Center for Gastroenterology, Teine Keijinkai Hospital
[ Summary ] An increasing number of intraductal papillary mucinous neoplasm (IPMN) patients are subjected to follow-up observations. Since IPMN progresses slowly this neoplasm have relatively good prognoses. In our center, surgical treatment is indicated for those nodules measuring more than 6mm in height in patients with branch duct IPMNs. Other patients are given follow-up observations. During our long-term follow-up of 182 IPMN cases, enlargement of nodule or cyst diameter was observed in 23 cases (12.6%), and surgery or autopsy were performed in 8 of these. The lesions were diagnosed as non-invasive cancer in 2, adenoma in 4 and hyperplasia in 2. There was no invasive cancer derived from IPMN. Twenty-two patientsdied during the observation period. Most of those patients died of other diseases or extrapancreatic malignancies. It should be carefully considered therefore, when deciding on treatment, whether IPMN should be involved in the prognosis for each case. Follow-up examinations are done initially at 3 months with US and CT so that no quick changes may be overlooked. After that, if there is no change in the lesions, observations are made every 6-12 months with CT or MRCP. It is important to simultaneously evaluate the whole pancreas in follow-up examinations for IPMN, considering the possible development of pancreatic cancer, and to further perform whole body examinations in cases with combined development of cancer in other organs.
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