Intraductal papillary mucinous neoplasm (IPMN) is an increasingly recognized entity representing a spectrum of benign and malignant neoplasms of the pancreas. Preoperative distinction between benign and malignant IPMNs remains difficult. Reported predictive factors for malignancy are size of the main pancreatic duct, cystic neoplasm, and mural nodule. We report herein the case of a 50-year-old woman in whom a large mural nodule (30 mm) in the dilated main pancreatic duct (16 mm in diameter) was detected by ultrasonography, computed tomography, and endoscopic retrograde cholangiopancreatography. Because the large mural nodule and dilatation of the main pancreatic duct were also detected by endoscopic ultrasonography (EUS) and intraductal ultrasonography (IDUS), the main-duct IPMN was considered to have malignant potential. Thus, pylorus-preserving pancreaticoduodenectomy with lymph node dissection was performed. The resected intraductal tumor appeared polypoid with a broad stalk and comprised a proliferation of mucin-containing columnar epithelial cells with papillary structures without malignant features. The final diagnosis was intraductal papillary mucinous adenoma of the pancreas. The size of the mural nodule and the final diagnosis in this case suggest that the introduction of a novel molecular-biological approach might be necessary for the precise preoperative diagnosis of main-duct IPMN and adequate surgical treatment.
Main-duct intraductal papillary mucinous adenoma of the pancreas with a large mural nodule. Publishing Authors By Initials
Main-duct intraductal papillary mucinous adenoma of the pancreas with a large mural nodule. Journal Published:
PUBLICATION TYPE: Journal Article
Journal: International journal of clinical oncology / Japan
VOLUME: 12
Page Numbers: 388-91
Journal Abbreviation: Int. J. Clin. Oncol.
ISSN: 1341-9625
DAY: 22
MONTH: 10
YEAR: 2007
Main-duct intraductal papillary mucinous adenoma of the pancreas with a large mural nodule. Information
Number of References:
LANGUAGE: eng
NlmUniqueID: 9616295
Main-duct intraductal papillary mucinous adenoma of the pancreas with a large mural nodule. Keywords Mesh Terms:
KEYWORDS:
MESH TERMS:
Chemical & Substance for Abstract: Main-duct intraductal papillary mucinous adenoma of the pancreas with a large mural nodule. Information
Substance Name:
Registry Number:
Grant and Affiliation Information for Main-duct intraductal papillary mucinous adenoma of the pancreas with a large mural nodule.
AFFILIATION: Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, Kihara 5200, Kiyotake, Miyazaki, 889-1692, Japan, kazuochi@med.miyazaki-u.ac.jp.
Country: Japan
AGENCY:
GRANT:
ACRONYM:
MEDLINETA: Int J Clin Oncol
REFSOURCE:
DATABASENAME:
ACCESSION NUMBER:
Number Hits: 0
Main-duct intraductal papillary mucinous adenoma of the pancreas with a large mural nodule Related Publications