Clinicopathological Features of Patients with Concomitant Intraductal Papillary Mucinous Neoplasm of the Pancreas and Pancreatic Endocrine Neoplasm

Goh, Brian K. P.; Ooi, London Lucien Peng Jin; Kumarasinghe, Marian Priyanthi; Tan, Yiwei; Peng-Cheow, Chung; Chow, Pierce K. H.; Chung, Fui; Wai-Wong, Keong

doi:10.1159/000097361

Cited by 40 publications

(29 citation statements)

References 21 publications

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“…Table I summarizes the clinicopathological features of the 15 previously reported cases of concomitant IPMN and NET (3,(5)(6)(7)(8)(9) as well as the present case. This condition mainly affects middle-aged females (average age, 63.1 years; range, 40-76 years; male/female ratio, 5:11).…”

Section: Discussionmentioning

confidence: 93%

Concomitant intraductal papillary mucinous neoplasm and neuroendocrine tumor of the pancreas

et al. 2012

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Abstract. Intraductal papillary mucinous neoplasm (IPMN) and neuroendocrine tumor (NET) of the pancreas are rare tumors and their association is not expected to be frequent. However, certain studies have suggested that the concomitant occurence of these tumors may be more frequent than previously thought. In the current study, we describe a case of concomitant occurrence of IPMN and NET of the pancreas and review the clinicopathological features of previously published cases and the current one. A 68-year-old female was incidentally found to have dilatation of the main pancreatic duct. A distal pancreatectomy was performed under the clinical diagnosis of IPMN. Histopathological analysis revealed concomitant IPMN (low-grade) and NET G1 of the pancreas. Review of the clinicopathological features of the 15 previously reported cases of concomitant IPMN and NET of the pancreas as well as the present one indicated that: i) this condition mainly affects middle-aged females; ii) the main symptom is abdominal or back pain, or no symptoms; iii) a hormone production symptom was observed in only one case; iv) the most common degree of dysplasia of IPMN is low grade; and v) the size of the NET is not particularly large (average 15.1 mm), although the clinical behavior is not always indolent (metastasis was observed in 3 cases). It is well known that IPMNs are associated with a high incidence of extrapancreatic malignancies, including colorectal and gastric carcinomas. Concomitant pancreatic NET and extrapancreatic malignancies may occur, therefore, systemic surveillance of extrapancreatic neoplasms and detection of concomitant NETs of the pancreas are necessary for patients with IPMN. IntroductionIntraductal papillary mucinous neoplasm (IPMN) is a rare intraductal epithelial neoplasm composed of mucin-producing cells arising in the main pancreatic duct or its branches (1). IPMNs are estimated to account for 1-3% of exocrine pancreatic neoplasms and 20% of all cystic neoplasms of the pancreas, and the incidence of this disease is considered to be increasing (1). The subtypes of IPMNs are recognized as main-duct and branch-duct types by macroscopic examination, and noninvasive IPMNs are classified into three categories on the basis of cytoarchitectural atypia: low-, intermediate-and high-grade dysplasia (1).Pancreatic neuroendocrine neoplasms are uncommon and represent 1-2% of all pancreatic neoplasms (2). According to the recent World Health Organization Classification of the Digestive System, neuroendocrine neoplasms are classified into three categories: neuroendocrine tumor (NET) G1 and G2 and neuroendocrine carcinoma (NEC; NET G3) (2).IPMN and NET of the pancreas are rare tumors and their association is not expected to be frequent. However, certain studies have suggested that the concomitant occurrence of these tumors may be more frequent than previously thought (3). In the current study, we describe a case of concomitant occurrence of IPMN and NET of the pancreas, and review the clinicopathological features of previously ...

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Section: Discussionmentioning

confidence: 93%

Concomitant intraductal papillary mucinous neoplasm and neuroendocrine tumor of the pancreas

et al. 2012

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“…Six out of the 61 patients in our series had invasive adenocarcinomas associated with IPMN. Pancreatic endocrine neoplasms are rarely observed within the pancreas involved with IPMN according to a recent report [22] .…”

Section: Discussionmentioning

confidence: 99%

Synchronous and Metachronous Extrapancreatic Malignant Neoplasms in Patients with Intraductal Papillary-Mucinous Neoplasm of the Pancreas

et al. 2008

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“…The incidence of concomitant IPMNs and NETs has been reported in a range from 2.6 to 4.6%, suggesting a nonrandom association [10][11][12]. In most cases, the coexistence of both tumors was an incidental discovery after the examination of the surgical specimen.…”

Section: Discussionmentioning

confidence: 99%

Collision of ductal adenocarcinoma and neuroendocrine tumor of the pancreas: a case report and review of the literature

et al. 2017

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Background: Simultaneous occurrence of exocrine and neuroendocrine tumors of the pancreas is very infrequent. We report a patient with an endocrine tumor in the pancreatic-duodenal area and extensive exocrine carcinoma involving the whole pancreas. Case presentation: A 69-year-old woman was hospitalized in May 2016 for epigastric pain and weight loss. Her past medical history revealed an undefined main pancreatic duct dilation that was subsequently confirmed at CT scan (23 mm) and endoscopic ultrasound. There was no evidence of pancreatic masses, but the cephalic portion of the main pancreatic duct presented hypoechoic nodules. A diagnosis of the main-duct intraductal papillary mucinous neoplasm was made, and the patient underwent total pancreatectomy. Pathological examination showed a collision tumor constituted by a ductal adenocarcinoma involving the whole pancreas and a neuroendocrine tumor located in the duodenal peripancreatic wall and the head of the pancreas. There was one peripancreatic lymph node metastasis from the ductal adenocarcinoma and eight node metastases from the neuroendocrine tumor. These findings suggested a diagnosis of collision of neuroendocrine and ductal adenocarcinomas of the pancreas. The postoperative course was uneventful. Conclusions: The coexistence of pancreatic endocrine and exocrine tumors is very uncommon. When present, problems in differential diagnosis may arise between mixed exocrine-endocrine carcinoma or the collision of separate tumors.

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Clinicopathological Features of Patients with Concomitant Intraductal Papillary Mucinous Neoplasm of the Pancreas and Pancreatic Endocrine Neoplasm

Cited by 40 publications

References 21 publications

Concomitant intraductal papillary mucinous neoplasm and neuroendocrine tumor of the pancreas

Concomitant intraductal papillary mucinous neoplasm and neuroendocrine tumor of the pancreas

Synchronous and Metachronous Extrapancreatic Malignant Neoplasms in Patients with Intraductal Papillary-Mucinous Neoplasm of the Pancreas

Collision of ductal adenocarcinoma and neuroendocrine tumor of the pancreas: a case report and review of the literature

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