Intraductal tubular papillary neoplasm (ITPN), a novel entity of pancreatic epithelial neoplasms and precursor of cancer: A case report and review of the literature

Abstract

HighlightsIntraductal tubular papillary neoplasm (ITPN) displays a very rare subtype of epithelial neoplasms of the pancreas.To date, little is known about ITPN and particularly about pancreatic cancer arising in this tumor entity.ITPN reveals a potential of malignant transformation. Radical surgical resection and oncologic follow-up is warranted.When compared to ductal adenocarcinoma, patients with ITPN reveal less lymph node metastasis and a better overall survival.

Intraductal Tubulopapillary Neoplasm of the Pancreas Presenting as a Localized Pancreatic Tumor in a 52-Year-Old Woman: Focusing on a Rare Pancreatic Malignancy and Contrasting to Intrapapillary Mucinous Neoplasm

“…A literature review of 30 case reports had analyzed the prognosis in 20 of the studies and reported average survival time to be 28.6 months post-diagnosis, with most cases having no evidence of remaining disease after resection and treatment [ 5 ]. A particular case report in which a patient with ITPN and no metastases underwent pylorus-preserving duodenopancreatectomy showed survival at five months post-surgery with no evidence of remaining disease [ 9 ]. However, the prognosis of ITPN is favorable in comparison to the more commonly encountered pancreatic ductal adenocarcinomas, where median disease-specific survival was 17.0 months in a dataset of 4383 patients [ 10 ].…”

Total Pancreatectomy with Splenectomy for Multifocal Intraductal Tubulopapillary Neoplasm (ITPN) of the Pancreas Associated with Invasive Component: Report of a Rare Case

“…ITPN is considered a precursor lesion to invasive pancreatic ductal adenocarcinoma [ 4 , 11 , 21 – 23 ]. Approximately 40% to 50% of ITPN cases harbor an invasive component and they should be referred to as cases of “ITPN with an associated invasive carcinoma” [ 2 , 7 , 10 , 22 ].…”

“…Approximately 40% to 50% of ITPN cases harbor an invasive component and they should be referred to as cases of “ITPN with an associated invasive carcinoma” [ 2 , 7 , 10 , 22 ]. Male sex, large tumor size, dilated pancreatic duct with pancreatoliths and high Ki-67 labelling index could be considered as predictive factors for invasiveness [ 2 , 23 ]. Rare cases of patients with lymphovascular and perineural invasion, lymph node and liver metastases are reported in literature [ 8 ].…”

“…Radical surgical treatment performed before ITPN evolves into an invasive carcinoma is recommended by some authors and has been associated with a better prognosis [ 2 , 23 ]. The most common surgical procedure for ITPN is pancreatoduodenectomy according to the literature [ 5 , 6 , 10 ].…”

“…Three patients with pancreatic ITPN and associated invasive cancer have been treated with adjuvant gemcitabine and capecitabine (Xeloda) [ 2 , 18 , 23 ]. Two of them were alive and disease-free 15 and 19 months after surgery [ 2 , 23 ], whereas the third was diagnosed with hepatic metastases in the fourth postoperative month [ 18 ].…”