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Article: Cystic, mucin-producing neoplasms of the pancreas: the distinguishing features of mucinous cystic neoplasms and intraductal papillary mucinous neoplasms.

Klimstra, David S

2006 Volume 22, Issue 4, Page(s) 318–329

Abstract: ... producing pancreatic neoplasms, most of which are now broadly classified as either mucinous cystic neoplasms ... MCNs) or intraductal papillary mucinous neoplasms (IPMNs). Although both share certain histological ... many advances in our understanding of the clinical, pathological, and molecular features of cystic mucin ...

Abstract	Perhaps due to the increasing use of sensitive cross-sectional imaging of the abdomen, cystic lesions of the pancreas are being increasingly recognized. In many such cases, biopsy or resection reveals a multilocular cyst lined by columnar mucinous epithelium. Over the past two to three decades, there have been many advances in our understanding of the clinical, pathological, and molecular features of cystic mucin-producing pancreatic neoplasms, most of which are now broadly classified as either mucinous cystic neoplasms (MCNs) or intraductal papillary mucinous neoplasms (IPMNs). Although both share certain histological features and both are regarded to represent preinvasive neoplasms with the potential to progress to invasive carcinoma, there are many significant differences in their pathology and clinical management. The purpose of this review is to highlight the clinical and pathological characteristics of MCNs and IPMNs, with an emphasis of the features that distinguish them and allow proper pathological subclassification.
MeSH term(s)	Adult ; Aged ; Carcinoma, Pancreatic Ductal/metabolism ; Carcinoma, Pancreatic Ductal/pathology ; Carcinoma, Papillary/metabolism ; Carcinoma, Papillary/pathology ; Cysts/pathology ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Mucins/metabolism ; Pancreatic Neoplasms/classification ; Pancreatic Neoplasms/metabolism ; Pancreatic Neoplasms/pathology ; Prognosis
Chemical Substances	Mucins
Language	English
Publishing date	2006-07-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	605834-6
ISSN	1930-1111 ; 0740-2570
ISSN (online)	1930-1111
ISSN	0740-2570
DOI	10.1053/j.semdp.2006.04.005
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Article: Mucin-producing neoplasms of the pancreas. Intraductal papillary and mucinous cystic neoplasms.

Shyr, Y M / Su, C H / Tsay, S H / Lui, W Y

Annals of surgery

1996 Volume 223, Issue 2, Page(s) 141–146

Abstract: ... intraductal papillary and mucinous cystic neoplasms identified from 1985 to 1994 in the Medical Center ... mucinous cystic neoplasms of the pancreas and clarified the similarities as well as the differences between ... presentations of mucinous cystic neoplasm were epigastric pain and abdominal mass. All four intraductal ...

Abstract	Objective: The authors compared the clinicopathologic features of the intraductal papillary and mucinous cystic neoplasms of the pancreas and clarified the similarities as well as the differences between these two tumors. In addition, they reviewed 104 cases of the intraductal papillary neoplasm in the English literature to provide a global view of the condition. Summary background data: Controversy about the term and clinicopathologic entity still exist regarding intraductal papillary neoplasm of the pancreas. Currently, with only a few cases of this rare tumor in each report, there continues to be inadequate knowledge available regarding the tumor and methods by which to distinguish it from the mucinous cystic neoplasm. Methods: Multiple demographic and clinicopathologic parameters were compared between intraductal papillary and mucinous cystic neoplasms identified from 1985 to 1994 in the Medical Center, Veterans General Hospital--Taipei. Results: There were four intraductal papillary adenocarcinomas and 10 mucinous cystic neoplasms (8 cystadenocarcinoma and 2 cystadenoma). The sex, age, size, tumor location, and pathologic findings were quite different between these two groups. Clinical presentation of intraductal papillary adenocarcinomas were similar to those of periampullary tumors. The most common presentations of mucinous cystic neoplasm were epigastric pain and abdominal mass. All four intraductal papillary adenocarcinoma showed mucin secretion from a patulous orifice of the ampulla of Vater and filling defects in the dilated main pancreatic duct by endoscopic retrograde cholangiopancreatography (ERCP). Accurate preoperative diagnosis was not easy regarding either group. Serum carbohydrate antigen 19-9 (CA 19-9) was more useful for diagnosis in both groups. Conclusions: The intraductal papillary neoplasm is a unique clinical entity but not a variant of mucinous cystic neoplasm in terms of sex, age, size, tumor location, or pathologic picture. The pathognomonic findings of ERCP should lead to diagnosis. Very aggressive surgical procedures should be attempted for these two mucin-producing neoplasms with low-grade malignancy.
MeSH term(s)	Adenocarcinoma, Papillary/metabolism ; Adenocarcinoma, Papillary/pathology ; Adult ; Aged ; Cystadenoma, Mucinous/metabolism ; Cystadenoma, Mucinous/pathology ; Female ; Humans ; Middle Aged ; Mucins/metabolism ; Pancreatic Ducts/metabolism ; Pancreatic Ducts/pathology ; Pancreatic Neoplasms/metabolism ; Pancreatic Neoplasms/pathology ; Retrospective Studies
Chemical Substances	Mucins
Language	English
Publishing date	1996-02
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Review
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/00000658-199602000-00005
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Article ; Online: Imaging and Cytopathological Criteria Indicating Malignancy in Mucin-Producing Pancreatic Neoplasms: A Series of 68 Histopathologically Confirmed Cases.

Salla, Charitini / Karvouni, Eleni / Nikas, Ilias / Ikonomakis, Aristidis / Konstantinou, Panagiotis / Karoumpalis, Ioannis / Sepsa, Athanasia / Papaparaskeva, Kleio / Tsopanomichalou, Maria / Georgiadou, Despoina / Kostopoulou, Akrivi / Tsiotos, Gregory / Theocharis, Stamatios / Sergentanis, Theodoros N / Politi, Ekaterini

Pancreas

2018 Volume 47, Issue 10, Page(s) 1283–1289

Abstract: ... specifically, 39 branch duct intraductal papillary mucinous neoplasms (BD-IPMNs), 21 main duct IPMNs, and 8 ... cystic neoplasms.: Methods: Sixty-eight consecutive, histopathologically confirmed mucin-producing ... mucinous cystic neoplasms. The associations between HGD/Ca in histopathology and findings of endoscopic ...

Abstract	Objectives: This study aims to evaluate the performance of clinical, imaging, and cytopathological criteria in the identification of high-grade dysplasia/carcinoma (HGD/Ca) in pancreatic mucin-producing cystic neoplasms. Methods: Sixty-eight consecutive, histopathologically confirmed mucin-producing cystic neoplasms, evaluated by endoscopic ultrasound-guided fine-needle aspiration, were enrolled; specifically, 39 branch duct intraductal papillary mucinous neoplasms (BD-IPMNs), 21 main duct IPMNs, and 8 mucinous cystic neoplasms. The associations between HGD/Ca in histopathology and findings of endoscopic ultrasound and cytology, demographic, lifestyle, and clinical parameters were evaluated, separately in IPMNs and mucinous cystic neoplasms. Results: Age 65 years or more was associated with HGD/Ca in IPMNs. In BD-IPMNs, cyst diameter 3 cm or greater (sensitivity, 68.8%; specificity, 65.2%), a mural nodule (sensitivity, 56.3%; specificity, 78.3%), main pancreatic duct diameter 5 to 9 mm (sensitivity, 50.0%; specificity, 87.0%), and suspicious cytology (sensitivity, 81.3%; specificity, 100%) signaled the presence of HGD/Ca. Similarly, in main duct IPMNs, suspicious cytology predicted HGD/Ca with high sensitivity (88.9%) and excellent specificity (100%). Regarding cytopathological criteria, in BD-IPMNs, HGD/Ca was associated with a high nuclear/cytoplasmic ratio, background necrosis, presence of papillary structures, hypochromatic nuclei, hyperchromatic nuclei, and major nuclear membrane irregularities (thickening and/or indentations). Conclusions: Clinical, imaging, and cytopathological criteria are useful in the identification of HGD/Ca in IPMNs.
MeSH term(s)	Adenocarcinoma, Mucinous/diagnostic imaging ; Adenocarcinoma, Mucinous/pathology ; Aged ; Carcinoma, Pancreatic Ductal/diagnostic imaging ; Carcinoma, Pancreatic Ductal/pathology ; Carcinoma, Papillary/diagnostic imaging ; Carcinoma, Papillary/pathology ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Cystic, Mucinous, and Serous/diagnostic imaging ; Neoplasms, Cystic, Mucinous, and Serous/pathology ; Pancreas/diagnostic imaging ; Pancreas/pathology ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/pathology
Language	English
Publishing date	2018-10-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	632831-3
ISSN	1536-4828 ; 0885-3177
ISSN (online)	1536-4828
ISSN	0885-3177
DOI	10.1097/MPA.0000000000001182
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Article ; Online: Management of mucin-producing cystic neoplasms of the pancreas.

Fritz, Stefan / Warshaw, Andrew L / Thayer, Sarah P

The oncologist

2009 Volume 14, Issue 2, Page(s) 125–136

Abstract: ... of mucinous cystic tumors: intraductal papillary mucinous neoplasms (IPMNs) of the pancreas, which are ... practice. Among these lesions, mucin-producing cystic neoplasms represent a recently described and unique ... mucinous cystic neoplasms (MCNs), which are defined by ovarian-like stroma and in most cases do not ...

Abstract	During the last decade small lesions of the pancreas have been increasingly recognized in clinical practice. Among these lesions, mucin-producing cystic neoplasms represent a recently described and unique entity among pancreatic tumors. In 1996, the World Health Organization distinguished two different types of mucinous cystic tumors: intraductal papillary mucinous neoplasms (IPMNs) of the pancreas, which are characterized by mucin production, cystic dilation of the pancreatic ducts, and intrapapillary growth, and mucinous cystic neoplasms (MCNs), which are defined by ovarian-like stroma and in most cases do not communicate with pancreatic ducts. Further, IPMNs can be subdivided into main-duct type, mixed-type, and branch-duct type tumors. Older data did not distinguish among different subsets of cystic neoplasms of the pancreas, and consequently many databases were inconsistent. Histopathologically, both IPMNs and MCNs demonstrate a wide spectrum of cellular atypia ranging from mild mucinous hyperplasia to invasive adenocarcinoma. Because mucinous cystic neoplasms of the pancreas show significant differences in clinical behavior from patient to patient, knowledge of the clinicopathologic characteristics and natural history of specific subtypes of IPMNs and MCNs has become crucial for physicians working in the field of gastroenterology. The present work offers an overview of current and generally accepted clinical guidelines for the diagnosis and treatment of IPMNs and MCNs.
MeSH term(s)	Carcinoma, Pancreatic Ductal/diagnosis ; Carcinoma, Pancreatic Ductal/metabolism ; Carcinoma, Pancreatic Ductal/therapy ; Cystadenocarcinoma, Mucinous/diagnosis ; Cystadenocarcinoma, Mucinous/metabolism ; Cystadenocarcinoma, Mucinous/therapy ; Humans ; Mucins/biosynthesis ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/metabolism ; Pancreatic Neoplasms/therapy
Chemical Substances	Mucins
Language	English
Publishing date	2009-02-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1409038-7
ISSN	1549-490X ; 1083-7159
ISSN (online)	1549-490X
ISSN	1083-7159
DOI	10.1634/theoncologist.2008-0200
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Zs.A 4845: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Cystic neoplasms of the pancreas with mucin-production.

Goh, B K P / Tan, Y M / Cheow, P C / Chung, Y F A / Chow, P K H / Wong, W K / Ooi, L L P J

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2005 Volume 31, Issue 3, Page(s) 282–287

Abstract: Aim: To compare the clinico-pathological features of intraductal papillary mucinous cystic tumours ... IPMT) and mucinous cystic tumours (MCT) of the pancreas.: Methods: Eighteen patients with IPMT and ... 18 with MCT who underwent surgical resection between 1990 and 2004 were retrospectively reviewed ...

Abstract	Aim: To compare the clinico-pathological features of intraductal papillary mucinous cystic tumours (IPMT) and mucinous cystic tumours (MCT) of the pancreas. Methods: Eighteen patients with IPMT and 18 with MCT who underwent surgical resection between 1990 and 2004 were retrospectively reviewed. Their clinico-pathological features were compared using univariate analysis. Statistical analyses of potential predictive factors of malignancy for each of these two groups were also conducted. Results: Patients with IPMT were found to be older (64+/-10 vs 43+/-18 years, p<0.001) and were predominantly male (male:female ratio, 5:4 vs 1:17, p=0.003) as compared to patients with MCT. MCTs were found in the body-tail region (100%) whereas IPMTs were more evenly distributed (50% in the head) (p=0.001). Pathologically, IPMT was distinct from MCT in terms of size (3.8+/-3.2 vs 9.1+/-4.4 cm, p=0.001), association with secondary pancreatitis (50 vs 0%, p=0.011), communication with the pancreatic duct (94 vs 0%, p<0.001), presence of a dilated main pancreatic duct (61 vs 0%, p<0.001) and the presence of ovarian-type stroma (0 vs 44%, p=0.003). Conclusion: IPMT and MCT are distinct clinico-pathological entities. This distinction is important as management and outcome of these entities may differ.
MeSH term(s)	Adult ; Aged ; Analysis of Variance ; Carcinoma, Pancreatic Ductal/pathology ; Carcinoma, Pancreatic Ductal/secretion ; Cystadenocarcinoma/pathology ; Cystadenocarcinoma/secretion ; Cystadenocarcinoma, Mucinous/pathology ; Cystadenocarcinoma, Papillary/pathology ; Cystadenoma/pathology ; Cystadenoma/secretion ; Cystadenoma, Mucinous/pathology ; Cystadenoma, Papillary/pathology ; Female ; Humans ; Male ; Middle Aged ; Mucins/secretion ; Pancreatic Neoplasms/etiology ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/secretion ; Pancreatitis/complications
Chemical Substances	Mucins
Language	English
Publishing date	2005-04
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	632519-1
ISSN	0748-7983
ISSN	0748-7983
DOI	10.1016/j.ejso.2004.12.007
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Zs.A 1149: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Mucin-producing neoplasms of the pancreas: an analysis of distinguishing clinical and epidemiologic characteristics.

Crippa, Stefano / Fernández-Del Castillo, Carlos / Salvia, Roberto / Finkelstein, Dianne / Bassi, Claudio / Domínguez, Ismael / Muzikansky, Alona / Thayer, Sarah P / Falconi, Massimo / Mino-Kenudson, Mari / Capelli, Paola / Lauwers, Gregory Y / Partelli, Stefano / Pederzoli, Paolo / Warshaw, Andrew L

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

2009 Volume 8, Issue 2, Page(s) 213–219

Abstract: ... neoplasms (MCNs) and main-duct, branch-duct, and combined intraductal papillary mucinous neoplasms (IPMNs ... Background & aims: Mucin-producing neoplasms (MPNs) of the pancreas include mucinous cystic ... respectively.: Conclusions: MPNs comprise 3 different neoplasms: MCNs, branch-duct IPMNs, and main-duct ...

Abstract	Background & aims: Mucin-producing neoplasms (MPNs) of the pancreas include mucinous cystic neoplasms (MCNs) and main-duct, branch-duct, and combined intraductal papillary mucinous neoplasms (IPMNs). MCNs and branch-duct IPMNs are frequently confused; it is unclear whether main-duct, combined, and branch-duct IPMNs are a different spectrum of the same disease. We evaluated their clinical and epidemiologic characteristics. Methods: Patients who underwent resection for histologically confirmed MPNs were identified (N = 557); specimens were reviewed and eventually reclassified. Results: One hundred sixty-eight patients (30%) had MCNs, 159 (28.5%) had branch-duct IPMNs, 149 (27%) had combined IPMNs, and 81 (14.5%) had main-duct IPMNs. Patients with MCNs were significantly younger and almost exclusively women; 44% of patients with main-duct or combined IPMNs and 57% of those with branch-duct IPMNs were women. MCNs were single lesions located in the distal pancreas (95%); 11% were invasive. IPMNs were more frequently found in the proximal pancreas; invasive cancer was found in 11%, 42%, and 48% of branch-duct, combined, and main-duct IPMNs, respectively (P = .001). Patients with invasive MCN and those with combined and main-duct IPMNs were older than those with noninvasive tumors. The 5-year disease-specific survival rate approached 100% for patients with noninvasive MPNs. The rates for those with invasive cancer were 58%, 56%, 51%, and 64% for invasive MCNs, branch-duct IPMNs, main-duct IPMNs, and combined IPMNs, respectively. Conclusions: MPNs comprise 3 different neoplasms: MCNs, branch-duct IPMNs, and main-duct IPMNs, including the combined type. These tumors have specific clinical, epidemiologic, and morphologic features that allow a reasonable degree of accuracy in preoperative diagnosis.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Carcinoma, Pancreatic Ductal/epidemiology ; Carcinoma, Pancreatic Ductal/pathology ; Female ; Humans ; Male ; Middle Aged ; Mucins/metabolism ; Neoplasms, Cystic, Mucinous, and Serous/epidemiology ; Neoplasms, Cystic, Mucinous, and Serous/pathology ; Pancreatic Neoplasms/epidemiology ; Pancreatic Neoplasms/pathology
Chemical Substances	Mucins
Language	English
Publishing date	2009-10-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2119789-1
ISSN	1542-7714 ; 1542-3565
ISSN (online)	1542-7714
ISSN	1542-3565
DOI	10.1016/j.cgh.2009.10.001
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Article: Mucin secreting cystic lesions of the pancreas: treatment by enucleation.

Madura, James A / Yum, Moo-Nahm / Lehman, Glen A / Sherman, Stuart / Schmidt, C Max

The American surgeon

2004 Volume 70, Issue 2, Page(s) 106–12; discussion 113

Abstract: ... intraductal papillary mucin-secreting neoplasms. The advent of computerized tomographic scanning ... without sacrifice of pancreatic parenchyma. However, many mucin-producing cystic lesions may evolve ... with the main pancreatic duct and lacked ovarian-type stroma, thus categorizing them as side-branch intraductal papillary ...

Abstract	Ninety per cent of pancreatic cysts are inflammatory pseudocysts. The other 10 per cent are congenital or neoplastic and include congenital true cysts, retention cysts, lymphoepithelial cysts, the mucinous cystadenoma, mucinous cystadenocarcinoma, and serous microcystic cystadenomas and the more recently described intraductal papillary mucin-secreting neoplasms. The advent of computerized tomographic scanning, endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasonography (EUS) has brought many of these lesions to light when they are minimally symptomatic or are incidentally found while investigating unrelated problems. If there is any suspicion of actual or potentially malignant disease, then total excision of the lesion with part of or the entire pancreas is indicated to achieve a likely cure, as survival is better than for the more common ductal adenocarcinomas. There are few reliable preoperative studies to distinguish accurately the etiology and prognosis of this spectrum of cystic lesions, and usually the actual diagnosis is made only at the time of operation or histopathologic examination after the cystic lesion has been biopsied or excised. If a cyst is confirmed to be totally benign, as in the congenital true cyst, lymphoepithelial cyst, or a benign mucinous cyst, they may lend themselves to nonoperative observation or excision without sacrifice of pancreatic parenchyma. However, many mucin-producing cystic lesions may evolve into a dysplastic or invasive malignant lesion requiring more aggressive resective treatment, and it is important not to miss that diagnosis early when cure is still possible. This report presents four benign mucin-secreting cysts treated by local excision. All four were in the head of the pancreas and communicated with the main pancreatic duct and lacked ovarian-type stroma, thus categorizing them as side-branch intraductal papillary mucinous neoplasms. These lesions were able to be easily dissected out of the pancreas with only one patient developing a transient pancreatic fistula. Intraoperative and final histopathology confirmed the benign status, and these patients have remained disease free 3 to 5 years postoperatively. A review of benign tumors reported to have been treated by cyst enucleation in the literature confirms the rationale of this approach in highly selected lesions.
MeSH term(s)	Adult ; Aged ; Cystadenoma, Mucinous/prevention & control ; Female ; Humans ; Male ; Middle Aged ; Mucins/secretion ; Pancreatic Cyst/pathology ; Pancreatic Cyst/secretion ; Pancreatic Cyst/surgery ; Pancreatic Ducts ; Pancreatic Neoplasms/prevention & control ; Patient Selection ; Prognosis
Chemical Substances	Mucins
Language	English
Publishing date	2004-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
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Article: Mucin-secreting tumors of the pancreas.

Lichtenstein, D R / Carr-Locke, D L

Gastrointestinal endoscopy clinics of North America

1995 Volume 5, Issue 1, Page(s) 237–258

Abstract: ... of pancreatic cysts, pseudocysts, and malignancy. Some authors propose that all mucin-producing tumors of the pancreas ... Mucinous pancreatic neoplasms present diagnostic and therapeutic challenges. These tumors behave ... indistinguishable pathologically. In mucinous cystic tumors, the mucus is secreted and retained within the cyst ...

Abstract	Mucinous pancreatic neoplasms present diagnostic and therapeutic challenges. These tumors behave in an indolent nature, with frequent overlap of symptoms and radiographic appearance with other forms of pancreatic cysts, pseudocysts, and malignancy. Some authors propose that all mucin-producing tumors of the pancreas are variants of the same basic entity and have subclassified them on the basis of their predominant location within the pancreas. These disorders must be considered in the evaluation of chronic abdominal pain, particularly in the presence of a cystic pancreatic lesion or when associated with idiopathic chronic or acute recurrent pancreatitis. The clinicopathologic features of IMHN overlap to a great extent with classic mucinous cystic neoplasms but are different significantly enough to be distinct clinical entities. These tumors originate from the pancreatic duct epithelium, produce mucin, demonstrate a papillary growth pattern, and are considered premalignant or frankly malignant at the time of diagnosis. Both lesions biologically are much less aggressive than that of pancreatic ductal adenocarcinoma and appear to infiltrate peripancreatic tissue and to metastasize to lymph nodes or other adjacent structures late in the course of disease. Nevertheless, IMHNs are located primarily in the head of the pancreas, commonly affect elderly men, and present clinically with obstructive pancreatitis, often leading to pancreatic insufficiency, whereas mucinous cystic neoplasms are more likely to develop in the pancreatic body or tail, predominate in young women, and present with symptoms referable to tumor compression of adjacent structures. The location of the lesion is the primary differentiating feature because the lining epithelium of the two tumor types is indistinguishable pathologically. In mucinous cystic tumors, the mucus is secreted and retained within the cyst lumen because of the absence of communication between the cyst and the main pancreatic duct. In contrast, mucus produced in MDE flows into the main pancreatic duct, resulting in obstructive pancreatitis and, ultimately, dilatation of the pancreatic duct. Intraductal mucus provides an important clue to the diagnosis of intraductal pancreatic neoplasms and, whenever present, should prompt an aggressive diagnostic evaluation. Both lesions are managed by resectional surgery because the opportunity for cure is high in the absence of metastatic disease.
MeSH term(s)	Adenoma/diagnosis ; Adenoma/secretion ; Adenoma/surgery ; Cholangiopancreatography, Endoscopic Retrograde ; Cystadenocarcinoma, Mucinous/diagnosis ; Cystadenocarcinoma, Mucinous/secretion ; Cystadenocarcinoma, Mucinous/surgery ; Cystadenoma, Mucinous/diagnosis ; Cystadenoma, Mucinous/secretion ; Cystadenoma, Mucinous/surgery ; Cystadenoma, Serous/diagnosis ; Cystadenoma, Serous/secretion ; Cystadenoma, Serous/surgery ; Diagnosis, Differential ; Female ; Humans ; Male ; Mucins/secretion ; Pancreatectomy ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/secretion ; Pancreatic Neoplasms/surgery ; Pancreatic Pseudocyst/diagnosis ; Pancreatic Pseudocyst/secretion ; Pancreatic Pseudocyst/surgery ; Prognosis ; Tomography, X-Ray Computed
Chemical Substances	Mucins
Language	English
Publishing date	1995-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1313994-0
ISSN	1558-1950 ; 1052-5157
ISSN (online)	1558-1950
ISSN	1052-5157
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Article: Surgical treatment for mucin-producing tumors of the pancreas.

Fujino, Y / Suzuki, Y / Ajiki, T / Tanioka, Y / Kuroda, Y

Hepato-gastroenterology

2001 Volume 48, Issue 40, Page(s) 1157–1161

Abstract: ... of intraductal papillary lesions (type Ib) and mucinous cystic neoplasms (type II). From pathological ... one patients with mucin-producing tumor of the pancreas were examined based on clinicopathological ... producing tumor of the pancreas from the clinicopathological and imaging features.: Methodology: Thirty ...

Abstract	Background/aims: Our objectives in this study were to evaluate the surgical treatment for mucin-producing tumor of the pancreas from the clinicopathological and imaging features. Methodology: Thirty-one patients with mucin-producing tumor of the pancreas were examined based on clinicopathological analyses to determine the appropriate surgical treatment. Results: The clinical and imaging features easily distinguished the main duct type of intraductal papillary lesions (type Ia), branch type of intraductal papillary lesions (type Ib) and mucinous cystic neoplasms (type II). From pathological examinations, a dilated main pancreatic duct had the malignant potentiality and multicentric development. Conclusions: Pancreatic segments containing a dilated main pancreatic duct should be resected in type Ia. Type Ib is sufficient for partial resection without lymphadenectomy. Type II also requires partial resection of the cystic neoplasm. A standard lymphadenectomy may be an option when type Ia and II show invasive features.
MeSH term(s)	Adenocarcinoma, Mucinous/surgery ; Adenoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Pancreatic Ductal/surgery ; Cholangiopancreatography, Endoscopic Retrograde ; Duodenoscopy ; Female ; Humans ; Lymph Node Excision ; Male ; Middle Aged ; Pancreatic Neoplasms/surgery
Language	English
Publishing date	2001-07
Publishing country	Greece
Document type	Journal Article
ZDB-ID	801013-4
ISSN	0172-6390
ISSN	0172-6390
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Article ; Online: Pylorus- and spleen-preserving total pancreatoduodenectomy with resection of both whole splenic vessels: feasibility and laparoscopic application to intraductal papillary mucin-producing tumors of the pancreas.

Choi, Sung Hoon / Hwang, Ho Kyoung / Kang, Chang Moo / Yoon, Chang Ik / Lee, Woo Jung

Surgical endoscopy

2012 Volume 26, Issue 7, Page(s) 2072–2077

Abstract: Background: Total pancreatectomy is recommended for intraductal papillary mucinous tumors ... with widespread involvement of the entire pancreas. Organ-preserving and minimally invasive surgery should be ... applied in benign and borderline pancreatic lesions.: Methods: Pylorus- and spleen-preserving total ...

Abstract	Background: Total pancreatectomy is recommended for intraductal papillary mucinous tumors with widespread involvement of the entire pancreas. Organ-preserving and minimally invasive surgery should be applied in benign and borderline pancreatic lesions. Methods: Pylorus- and spleen-preserving total pancreatoduodenectomy (PpSpTPD) with segmental resection of both splenic vessels was attempted for five patients. The technique was based on the concepts of two surgical procedures: pylorus-preserving pancreatoduodenectomy and distal pancreatectomy with segmental resection of splenic vessels ("extended" Warshaw's procedure). Results: Three patients underwent laparoscopic-assisted PpSpTPD and two underwent open surgery. No mortality was noted. Short-term follow-up (median, 28 months) suggested that all patients tolerated the insulin therapy and showed relatively good nutritional status. Only minimal to moderate perigastric fundal varices were noted without gastrointestinal bleeding. Conclusions: PpSpTPD with segmental resection of both splenic vessels is feasible and safe. Even a minimally invasive approach can be indicated in selected patients.
MeSH term(s)	Abdominal Pain/etiology ; Aged ; Carcinoma, Pancreatic Ductal/surgery ; Feasibility Studies ; Female ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Neoplasms, Cystic, Mucinous, and Serous/surgery ; Organ Sparing Treatments/methods ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy/methods ; Pylorus/surgery ; Spleen/surgery ; Treatment Outcome
Language	English
Publishing date	2012-01-12
Publishing country	Germany
Document type	Evaluation Study ; Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-011-2113-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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