| Theme |
The Current State of Management of Intraductal Papillary Mucinous Neoplasm (IPMN) of the Pancreas |
| Title |
Natural History of BD-IPMN |
| Author |
Hiroyuki Maguchi |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author |
Tosifumi Kin |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author |
Kei Yane |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author |
Manabu Osanai |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author |
Akio Katanuma |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| Author |
Kuniyuki Takahashi |
Center for Gastroenterology, Teine-Keijinkai Hospital |
| [ Summary ] |
According to published reports on the follow-up of branch-duct intraductal papillary mucinous neoplasm (BD-IPMN), the mean frequencies of morphological changes detected from the imaging findings and that of malignant transformation were 25.5 % and 3.0 % of all cases during the follow-up period, respectively. The mean frequencies of progression and of malignancy in patients with BD-IPMN without a mural nodule (MN) at the initial diagnosis were 16.2 % and 1.9 % during follow-up, respectively. A multicenter study in Japan reported that the frequencies of progression in BD-IPMN patients with or without MN were 22.6 % and 17.8 %, respectively. We compared the cumulative progression rate between BD-IPMN with or without MN diagnosed at our center. The 5-year and 10-year cumulative progression rates in BD-IPMN cases with or without MN were 28.6 %, 51.0 %, and 7.8 %, 29.7 %, respectively. Therefore, it is important to evaluate for the presence of MN on EUS at the initial diagnosis for predicting progression at follow-up.
In contrast, the mean frequency of occurrence of pancreatic ductal adenocarcinoma (PDAC) concomitant with IPMN was 4.3％ during follow-up, which was in accordance with previously published reports. The 5-year and 10-year cumulative occurrence rate of PDAC concomitant with BD-IPMN in our center was 2.9 % and 7.1 %, respectively. Special attention should be paid to the occurrence of PDAC in the entire pancreas during follow-up examinations in patients with BD-IPMN ; in addition, shorter surveillance intervals are required for these patients. |