Management of Mucin-Producing Cystic Neoplasms of the Pancreas

被引:25
作者
Fritz, Stefan [1 ]
Warshaw, Andrew L. [1 ]
Thayer, Sarah P. [1 ]
机构
[1] Massachusetts Gen Hosp, Dept Surg, Boston, MA 02114 USA
关键词
Pancreas; Intraductal papillary mucinous neoplasm; Mucinous cystic neoplasm; Pancreatectomy; IPMN; MCN; INTRADUCTAL PAPILLARY NEOPLASMS; K-RAS MUTATIONS; TERM-FOLLOW-UP; CLINICOPATHOLOGICAL FEATURES; PERORAL PANCREATOSCOPY; SURGICAL RESECTION; DIFFERENTIAL-DIAGNOSIS; DUCTAL ADENOCARCINOMA; ENDOSCOPIC RETROGRADE; SYMPTOMATIC PATIENTS;
D O I
10.1634/theoncologist.2008-0200
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 sub-types 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. The Oncologist 2009; 14: 125-136
引用
收藏
页码:125 / 136
页数:12
相关论文
共 124 条
  • [11] Ten-year experience with 733 pancreatic resections - Changing indications, older patients, and decreasing length of hospitalization
    Balcom, JH
    Rattner, DW
    Warshaw, AL
    Chang, Y
    Fernandez-del Castillo, C
    [J]. ARCHIVES OF SURGERY, 2001, 136 (04) : 391 - 397
  • [12] Bendall H.B., 2001, INT J MARITIME EC, V3, P262, DOI DOI 10.1057/PALGRAVE.IJME.9100018>
  • [13] Diagnosis of pancreatic cystic neoplasms: A report of the cooperative pancreatic cyst study
    Brugge, WR
    Lewandrowski, K
    Lee-Lewandrowski, E
    Centeno, BA
    Szydlo, T
    Regan, S
    del Castillo, CF
    Warshaw, AL
    [J]. GASTROENTEROLOGY, 2004, 126 (05) : 1330 - 1336
  • [14] Callery M, 2003, ARCH SURG-CHICAGO, V138, P433
  • [15] Cameron JL, 2006, ANN SURG, V244, P10, DOI 10.1097/01.sla.0000217673.04165.ea
  • [16] Cameron JL, 1997, ANN SURG, V226, P498
  • [17] Branch duct IPMTs: value of cross-sectional imaging in the assessment of biological behavior and follow-up
    Carbognin, G
    Zamboni, G
    Pinali, L
    Dalla Chiara, E
    Girardi, V
    Salvia, R
    Mucelli, RP
    [J]. ABDOMINAL IMAGING, 2006, 31 (03): : 320 - 325
  • [18] Study of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas
    Chari, ST
    Yadav, D
    Smyrk, TC
    DiMagno, EP
    Miller, LJ
    Raimondo, M
    Clain, JE
    Norton, IA
    Pearson, RK
    Petersen, BT
    Wiersema, MJ
    Farnell, MB
    Sarr, MG
    [J]. GASTROENTEROLOGY, 2002, 123 (05) : 1500 - 1507
  • [19] Intraductal papillary mucinous neoplasm of the pancreas in a patient with attenuated familial adenomatous polyposis
    Chetty, R
    Salahshor, S
    Bapat, B
    Berk, T
    Croitoru, M
    Gallinger, S
    [J]. JOURNAL OF CLINICAL PATHOLOGY, 2005, 58 (01) : 97 - 101
  • [20] Intraductal papillary mucinous tumour of the pancreas: differentiation of malignancy and benignancy by CT
    Chiu, S. S. -H.
    Lim, J. H.
    Lee, W. J.
    Chang, K. T.
    Oh, D. K.
    Lee, K. T.
    Lee, J. K.
    Choi, S. H.
    [J]. CLINICAL RADIOLOGY, 2006, 61 (09) : 776 - 783