Intraductal papillary mucinous tumors and mucinous cystic tumors of the pancreas: imaging

Choe, Kyuran A.

doi:10.1007/s00534-002-0740-8

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…In terms of the unique pathological characteristics of IPMT, the appropriate surgical resection for IPMT has been debated for years 3. Although appropriate management may depend on the location and size of the IPMT, and, most importantly, whether the IPMT is benign or malignant, the inconclusive discussions may be explained, in part, by the fact that preoperative diagnosis of the tumor is occasionally dificult 8. Even though IPMT can be diagnosed preoperatively by imaging analyses, diagnosis as to whether the tumor is malignant or benign is generally impossible.…”

Section: Discussionmentioning

confidence: 99%

“…3 Although appropriate management may depend on the location and size of the IPMT, and, most importantly, whether the IPMT is benign or malignant, the inconclusive discussions may be explained, in part, by the fact that preoperative diagnosis of the tumor is occasionally dificult. 8 Even though IPMT can be diagnosed preoperatively by imaging analyses, diag- Reveal that the tumor was an intraductal papillary adenoma with severe atypia. c, d Show villous and/or papillary proliferation of the tall columnar epithelium in the duct structure.…”

Section: Discussionmentioning

confidence: 99%

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Intraductal papillary-mucinous tumor of the pancreas head with complete absence of the ventral pancreatic duct of Wirsung

Sakurai

Matsubara

Imazu

et al. 2004

J Hepatobiliary Pancreat Surg

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A case of intraductal papillary mucinous tumor of the pancreas with complete absence of the ventral pancreatic duct of Wirsung is presented. A 74-year-old Japanese man was admitted to our hospital because of elevated serum amylase concentration. Abdominal computed tomography (CT) scanning revealed diffuse dilatation of the main pancreatic duct and a diffuse and uncircumscribed area with heterogeneous density in the pancreas head. Endoscopic retrograde cholangiopancreatography revealed that the main pancreatic duct was connected with an accessory papilla and was diffusely dilated, without any irregularity of the duct wall being observed in the entire length of the duct. The common bile duct was detected only by cannulation through Vater's papilla, and no pancreatic duct or its communicating branch was found. Some branches, directed to the dorsal portion of the pancreas head, were found arising from the accessory pancreatic duct. Intraductal ultrasound examination performed through the accessory papilla and the common bile duct revealed a small tumor with a heterogeneous echo level in the pancreas head. From these findings, intraductal papillary-mucinous tumor (IPMT) occurring in the pancreas head was diagnosed, and pylorus-preserving pancreaticoduodenectomy was performed. The resected specimen revealed IPMT in the pancreas head. A roentgenographic study of the resected specimen revealed a defect caused by the tumor located in the pancreatic duct connected with the accessory papilla and showed that there was complete absence of the pancreatic duct connected with Vater's papilla. Surgical resection enabled us to completely analyze the duct system of pancreas divisum. Although it is not known whether there is a relationship between the pathogenesis of IPMT and embryological anomaly of the pancreatic duct system, this case may provide an insight into the pathogenesis of IPMT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intraductal papillary-mucinous tumor of the pancreas head with complete absence of the ventral pancreatic duct of Wirsung

Sakurai

Matsubara

Imazu

et al. 2004

J Hepatobiliary Pancreat Surg

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“…MRI shows MPD dilation, and is better to detect intramural nodules and their connection to MPD, than Endoscopic Retrograde Cholangiopancreatography (ERCP). Despite the excellent images obtained by CT and MRI they do not exhibit high diagnostic accuracy in determining the presence of malignancy [60].…”

Section: Transabdominal Ultrasound (Us) Computerized Tomography (Ct)mentioning

confidence: 97%

“…Tiny cysts may occur in the wall of MCA and are sometimes diagnosed as mural nodules [28]. These characteristics can be clearly demonstrated by MRCP [60]. Communication between a PCL and the MPD is less common, but this finding does not make a definite diagnosis of MCN [25,28,60].…”

Section: Transabdominal Ultrasound (Us) Computerized Tomography (Ct)mentioning

confidence: 99%

“…These characteristics can be clearly demonstrated by MRCP [60]. Communication between a PCL and the MPD is less common, but this finding does not make a definite diagnosis of MCN [25,28,60]. The information provided by CT, MRI and EUS (detection of multiple septa within the cysts and nodules adhered to the cyst wall) can make the differential diagnosis between MCA and a pancreatic pseudocyst (PPC) [11,16].…”

Section: Transabdominal Ultrasound (Us) Computerized Tomography (Ct)mentioning

confidence: 99%

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Precursor Lesions of Pancreatic Cancer: A Current Appraisal on Diagnosis

Ardengh

2012

J. Anal. Oncol.

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The dramatic increase in the number of patients diagnosed with incidental pancreatic cysts through imaging methods provides a unique opportunity to detect and treat these precursor lesions of ductal adenocarcinoma before their manifestation. However, without any reliable biomarkers, the cost-effectiveness and the limited accuracy of highresolution imaging techniques for diagnose and staging seems troublesome. Small pancreatic cysts can be easily detected, but many are clinically irrelevant and are not harmful to the patient. Furthermore, patients with clinically benign lesions are at high risk of overtreatment and morbidity and mortality from unnecessary surgical intervention. It is believed that cyst fluid analysis may provide important information for a possible diagnosis, allowing stratification and treatment of these patients. Anyway, only the logical reasoning based on all available information (medical history, imaging, and laboratory analysis of the aspirated cyst fluid) can adequately stratify patients. It has been considered that there are three precursor lesions of the pancreatic cancer (PC): mucinous cystadenoma (MCA), intraductal papillary mucinous tumor (IPMT) and pancreatic intraepithelial neoplasia (PanIN). MCA and IPMT can be diagnosed by imaging methods, but PanIN are difficult to be identified. They must be detected and treated as soon as possible, as this is the only way to increase survival and reduce mortality of pancreatic ductal adenocarcinoma. The aim of this work is to establish diagnosis, staging, and the pathological findings and to compare the effectiveness and accuracy of the other imaging methods versus endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) for diagnosis of malignancy in the precursor lesions of pancreatic cancer.

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Magnetic resonance diffusion-weighted imaging in the characterization of pancreatic mucinous cystic lesions

Fatima¹,

Ichikawa²,

Motosugi³

et al. 2011

Clinical Radiology

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Intraductal papillary mucinous tumors and mucinous cystic tumors of the pancreas: imaging

Cited by 6 publications

References 29 publications

Intraductal papillary-mucinous tumor of the pancreas head with complete absence of the ventral pancreatic duct of Wirsung

Intraductal papillary-mucinous tumor of the pancreas head with complete absence of the ventral pancreatic duct of Wirsung

Precursor Lesions of Pancreatic Cancer: A Current Appraisal on Diagnosis

Magnetic resonance diffusion-weighted imaging in the characterization of pancreatic mucinous cystic lesions

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