Intraductal Papillary Mucinous Neoplasms of the Pancreas: Clinical Surveillance and Malignant Progression, Multifocality and Implications of a Field-Defect

Helen Elaine Remotti; Megan Winner; Muhammad Wasif Saif

doi:10.6092/1590-8577/713

Helen Elaine Remotti Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital. NewYork, NY, USA
Megan Winner Department of Surgery, Columbia University Medical Center and the New York Presbyterian Hospital. NewYork, NY, USA
Muhammad Wasif Saif Department of Medicine, Division of Hematology and Oncology, Columbia University Medical Center and the New York Presbyterian Hospital. NewYork, NY, USA

DOI: https://doi.org/10.6092/1590-8577/713

Keywords: Carcinoma, Pancreatic Ductal, Early Detection of Cancer, Pancreatic Cyst, Pancreatic Neoplasms, Population Surveillance

Abstract

Intraductal papillary mucinous neoplasms (IPMNs) are a heterogeneous group of mucin producing cystic tumors that involve the main pancreatic duct and/or branch ducts and may be associated with invasive carcinoma. Predicting the risk of malignant transformation of an IPMN lesion can be challenging. The Sendai criteria, based in large part on radiographic imaging features, help guide surgical intervention based on the stratification of cysts into high and low risk lesions for malignancy. Invasive carcinoma may develop in the index IPMN lesion or in a separate site within the pancreas, supporting the concept of a field defect in IPMN tumorigenesis. This stresses the importance of evaluation of the entire pancreas upon diagnosis of IPMN and continued surveillance of the residual pancreas following resection. Herein, the authors summarize the data presented at the 2012 ASCO Gastrointestinal Cancers Symposium regarding prevalence and site of invasive carcinoma detected in patients undergoing surveillance for IPMN (Abstract #152).

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Author Biography

Helen Elaine Remotti, Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital. NewYork, NY, USA

Pathology and Cell Biology, Assistant Professor

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