scholarly journals The Pathological Features and Prognoses of Intraductal Papillary Mucinous Neoplasm and Mucinous Cystic Neoplasm After Surgical Resection: A Single Institution Series

2020 ◽  
Author(s):  
Yuqiong Li ◽  
Zhongfei Zhu ◽  
Lisi Peng ◽  
Zhendong Jin ◽  
Liqi Sun ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Study Cohort ◽  
Single Institution ◽  
Cystic Neoplasms ◽  
Mucinous Neoplasms ◽  
Transformation Potential ◽  
Independent Risk Factors

Abstract Background: Intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) represent the tumors with malignant transformation potential. The objective of the study was to verify their pathological characteristics, prognoses, and recurrence factors. Methods: 218 IPMNs and 27 MCNs resected at a single institution were included. The demographic, preoperative, histopathological and follow-up data of the patients were recorded and analyzed. Results: Of the 218 IPMN and 27 MCN patients, 93 (42.7%) and 8 (29.6 %) cases were malignant, respectively. IPMNs occurred in older patients compared with MCN patients (median 63 years vs 54 years, P<0.0001) and MCNs occurred exclusively in females (100%). Of the overall study cohort, the pathological specimens presented peripheral invasion in 37 (15.1%) patients and incisal margin invasion was observed in 46 (18.8%) patients. After a median follow-up of 34 months, 37(14.9%) patients relapsed. The 1, 3, 5 -year overall survival rate (OS) and diseases-free survival (DFS) rate for IPMNs were 98.75%, 98.75%, 97.5%, and 85.7%, 81.1%, 80.6%; and for MCNs the rates were 95.7%, 95.7%, 95.7%, and 91.3%%, 87.0%, 87.0%, respectively. There were four independent risk factors associated with recurrence: pathological diagnoses with malignancy (Odds rate, OR=3.65), presence of oncocytic type for IPMN (OR=1.69), peripheral invasion (OR=12.87) and incisal margin invasion (OR=1.99). Conclusions: IPMNs and MCNs are indolent tumors with favorable prognoses after surgical resection in terms of their relatively high OS and DFS rate. Patients with malignant pathological-related diagnoses should accept strict tumor surveillance in view of their higher risk of recurrence.

scholarly journals The pathological features and prognoses of intraductal papillary mucinous neoplasm and mucinous cystic neoplasm after surgical resection: a single institution series

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Yuqiong Li ◽  
Zhongfei Zhu ◽  
Lisi Peng ◽  
Zhendong Jin ◽  
Liqi Sun ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Disease Free Survival ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Study Cohort ◽  
Single Institution ◽  
Cystic Neoplasms ◽  
Initial Surgery ◽  
Transformation Potential

Abstract Background Intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) represent the tumors with malignant transformation potential. The objective of the study was to verify their pathological characteristics, prognoses, and recurrence factors. Methods Two hundred eighteen IPMNs and 27 MCNs resected at a single institution were included. The demographic, preoperative, histopathological, and follow-up data of the patients were recorded and analyzed. Overall survival (OS) and disease-free survival (DFS) were defined as the interval from the date of initial surgery to death or the last follow-up (OS) and to diagnosis of recurrence or death at follow-up (DFS). Results Of the 218 IPMN and 27 MCN patients, 93 (42.7%) and 8 (29.6%) cases were malignant, respectively. IPMNs occurred in older patients compared with MCN patients (median 63 years vs 54 years, P < 0.0001), and MCNs occurred exclusively in females (100%). Of the overall study cohort, the pathological specimens presented peripheral invasion in 37 (15.1%) patients and incisal margin invasion was observed in 46 (18.8%) patients. After a median follow-up of 34 months, 37 (14.9%) patients relapsed. The 5-year OS and DFS rates of IPMNs were 97.5% and 80.6%; and the OS and DFS rates of MCNs were 95.7% and 87.0%, respectively. There were four independent risk factors associated with recurrence: pathological diagnoses with malignancy (odds ratio, OR = 3.65), presence of oncocytic type for IPMN (OR = 1.69), peripheral invasion (OR = 12.87), and incisal margin invasion (OR = 1.99). Conclusions IPMNs and MCNs are indolent tumors with favorable prognoses after surgical resection in terms of their relatively high OS and DFS rate. Patients with malignant pathological-related diagnoses should accept strict tumor surveillance in view of their higher risk of recurrence.

scholarly journals The pathological features and prognoses of intraductal papillary mucinous neoplasm and mucinous cystic neoplasm after surgical resection: a single institution series

2020 ◽  
Author(s):  
Yuqiong Li ◽  
Zhongfei Zhu ◽  
Lisi Peng ◽  
Zhendong Jin ◽  
Liqi Sun ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Disease Free Survival ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Study Cohort ◽  
Single Institution ◽  
Cystic Neoplasms ◽  
Initial Surgery ◽  
Transformation Potential

Abstract Background: Intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) represent the tumors with malignant transformation potential. The objective of the study was to verify their pathological characteristics, prognoses, and recurrence factors.Methods: 218 IPMNs and 27 MCNs resected at a single institution were included. The demographic, preoperative, histopathological and follow-up data of the patients were recorded and analyzed. Overall survival (OS) and disease-free survival (DFS) were defined as the interval from the date of initial surgery to death or the last follow up (OS) and to diagnosis of recurrence or death at follow-up (DFS).Results: Of the 218 IPMN and 27 MCN patients, 93 (42.7%) and 8 (29.6 %) cases were malignant, respectively. IPMNs occurred in older patients compared with MCN patients (median 63 years vs 54 years, P<0.0001) and MCNs occurred exclusively in females (100%). Of the overall study cohort, the pathological specimens presented peripheral invasion in 37 (15.1%) patients and incisal margin invasion was observed in 46 (18.8%) patients. After a median follow-up of 34 months, 37(14.9%) patients relapsed. The 5-year OS and DFS rate of IPMNs were 97.5% and 80.6%; and the OS and DFS rates of MCNs were 95.7% and 87.0%, respectively. There were four independent risk factors associated with recurrence: pathological diagnoses with malignancy (Odds ratio, OR=3.65), presence of oncocytic type for IPMN (OR=1.69), peripheral invasion (OR=12.87) and incisal margin invasion (OR=1.99).Conclusions: IPMNs and MCNs are indolent tumors with favorable prognoses after surgical resection in terms of their relatively high OS and DFS rate. Patients with malignant pathological-related diagnoses should accept strict tumor surveillance in view of their higher risk of recurrence.

scholarly journals European evidence-based guidelines on pancreatic cystic neoplasms

Gut ◽  
2018 ◽  
Vol 67 (5) ◽  
pp. 789-804 ◽  
Author(s):  
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Evidence Based ◽  
Indications For Surgery ◽  
Cystic Neoplasms ◽  
Serous Cystic Neoplasm ◽  
Pancreatic Cystic Neoplasms ◽  
Grade Methodology ◽  
Evidence Based Guidelines

Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring <40 mm without an enhancing nodule. Relative indications for surgery in IPMN include a main pancreatic duct (MPD) diameter between 5 and 9.9 mm or a cyst diameter ≥40 mm. Absolute indications for surgery in IPMN, due to the high-risk of malignant transformation, include jaundice, an enhancing mural nodule >5 mm, and MPD diameter >10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.

scholarly journals Branch Duct Intraductal Papillary Mucinous Neoplasms: Recommendations for Follow-Up and Surgery

2020 ◽  
Vol 109 (1) ◽  
pp. 34-41
Author(s):  
A. Caravati ◽  
S. Andrianello ◽  
T. Pollini ◽  
M. Biancotto ◽  
A. Balduzzi ◽  
...  
Keyword(s):  
High Volume ◽  
Cystic Neoplasm ◽  
Pancreatic Cysts ◽  
Intraductal Papillary Mucinous Neoplasms ◽  
Branch Duct ◽  
Cystic Neoplasms ◽  
Increased Risk ◽  
Mucinous Neoplasms ◽  
Risk Of Malignancy

Background and Aims: Pancreatic cysts are increasingly diagnosed, mainly during abdominal imaging performed for other reasons. Between pancreatic cystic neoplasm, intraductal papillary mucinous neoplasms are the most common pre-malignant entities. Intraductal papillary mucinous neoplasms involving side branches overall harbor a low risk of malignancy, and in the recent past, a progressively more conservative approach has been consolidated. Purpose of this report is to summarize the evidence supporting the current practice for the management of branch duct intraductal papillary mucinous neoplasm and to offer a useful practical guide from first observation to post-operative follow-up. Materials and Methods: Review of the most important scientific literature on intraductal papillary mucinous neoplasms was made. In this review article, we also report the experience of a high volume center in managing Pancreatic cystic neoplasms. Results: The correct management during surveillance still is a matter of debate, since many guidelines have been published suggesting different clinical approaches. Recently, follow-up discontinuation has also been proposed in selected cases. Conclusion: Despite significant improvements made by the increase of evidence, selecting surgical candidates because of an increased risk of malignant progression remains an unsolved issue and a hot topic for pancreatologists.

scholarly journals Giant mucinous cystic neoplasm of the pancreas

2019 ◽  
Vol 17 (3) ◽  
pp. 273-276
Author(s):  
A. Saroglu ◽  
A. Julianov
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Low Grade ◽  
Cystic Neoplasms ◽  
Mucinous Cystic Neoplasms ◽  
Distal Pancreas ◽  
Hormone Sensitive ◽  
Distal Pancreatosplenectomy ◽  
Left Abdomen

Mucinous cystic neoplasms (MCN) of the pancreas occur mostly in females and are potentially sex hormone-sensitive. MCNs are more common in women with a peak incidence in the fifth decade. They are usually located in the distal pancreas, and frequently grow up to a size of 8–10 cm. We report a case of giant MCN of the pancreas in a 31-year old female patient, occupying entire left abdomen, successfully treated with distal pancreatosplenectomy. Histology demonstrated MCN with low-grade dysplasia. At 4 year of follow-up, the patient is free of disease.

scholarly journals Surgical resection of mucinous cystic neoplasm which showed increase and decrease in size over 30-months follow-up: A case report

Suizo ◽  
2019 ◽  
Vol 34 (5) ◽  
pp. 262-269
Author(s):  
Makoto TAKAHASHI ◽  
Takashi HATORI ◽  
Tomohisa KADOMURA ◽  
Atsushi KATO ◽  
Yoshifumi IKEDA ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Resection ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm

A case of pancreatic mucinous cystic neoplasm: long-term follow-up with ultrasonography

Choonpa Igaku ◽  
2011 ◽  
Vol 38 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Junko FUKUDA ◽  
Sachiko TANAKA ◽  
Miho NAKAO ◽  
Eri UEDA ◽  
Reiko SUZUKI ◽  
...  
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Long Term Follow Up

What is the reasonable option for elderly patients with incidental pancreatic cystic neoplasms? Follow-up observation versus surgical resection

2016 ◽  
Vol 17 (2) ◽  
pp. 256-261
Author(s):  
Hyo Jung Kim ◽  
Jae Seon Kim ◽  
Jae Min Lee ◽  
Moon Kyung Joo ◽  
Beom Jae Lee ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Surgical Resection ◽  
Cystic Neoplasms ◽  
Pancreatic Cystic Neoplasms

Intralobular Distribution of Ovarian-like Stroma in Pancreatic Mucinous Cystic Neoplasms: Hypothesis on Its Tumorigenesis

2021 ◽  
Author(s):  
Yuki Fukumura ◽  
Yuko Kinowaki ◽  
Yoko Matsuda ◽  
Masaru Takase ◽  
Momoko Tonosaki ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Wnt Pathway ◽  
Smooth Muscle Actin ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Pancreatic Ducts ◽  
Low Grade ◽  
Muscle Actin ◽  
Cystic Neoplasms ◽  
Mucinous Cystic Neoplasms

Abstract Pancreatic mucinous cystic neoplasm (MCN) harbors two histological components, tumor epithelia and ovarian-like stroma (OLS). To examine the tumorigenesis of pancreatic MCNs, this study analyzed the distribution, amount, immunohistochemical phenotype, presence of theca cells of the OLS, and the alteration of tumor epithelium of 29 surgically resected MCN cases and compared them with tumor sizes. Non-mucinous type epithelium was present in all low-grade MCNs but its ratio decreased with tumor size (p < 0.05), suggesting that epithelial mucinous changes are a progression phenomenon. The intralobular distribution of OLS was observed in 27.6 % of MCN cases and its existence related to a smaller size (p< 0.05), suggesting intralobular generation of MCNs. Nuclear expression of β-catenin was observed for OLS of everywhere, suggesting consistent activation of the Wnt pathway for OLS. Three MCN cases (10.3%) contained a-smooth muscle actin (SMA)-negative OLS, where OLS surrounding dilated pancreatic ducts or MCN cysts were a-SMA-positive and otherwise negative, suggesting that a-SMA-positivity is an acquired phenomenon of OLS. With this study, we could hypothesize that pancreatic MCNs may generate intralobularly. Epithelial mucinous change and a-SMA-positivity of OLS may be progression phenomena. This is the first study to show the intralobular distribution of OLS.

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