title: Intraductal papillary mucinous tumours of the pancreas. Clinical and therapeutic issues in 32 patients.
abstract: OBJECTIVE
  The clinical presentation, pancreatographic findings, and outcome of patients with intraductal papillary mucinous tumours have not been reported in a large patient series in the English literature. This study reviewed 32 patients diagnosed between 1980 and 1994, with special attention to these features.
  
  
  METHODS
  Data on 24 operated and eight non-operated patients were abstracted from inpatient, outpatient, and procedure records.
  
  
  RESULTS
  Acute pancreatitis was the most common presentation seen in 56% of patients. Relapses occurred during an average of 43 months before diagnosis. A patulous papilla was observed in 55% of the cases. Endoscopic pancreatography showed communicating cysts, a diffusely dilated main pancreatic duct, and amorphous defects in 42, 71, and 97% respectively. An invasive carcinoma was found in nine of 24 (37.5%) of operated patients: six of the patients (66%) died or developed metastases within three years after surgery. No mortality was related to the tumour in absence of invasive carcinoma. Benign recurrence on the remaining pancreas was unusual and occurred late after surgery.
  
  
  CONCLUSIONS
  Intraductal papillary mucinous tumours must be considered in the differential diagnosis of relapsing pancreatitis. Despite slow growing, these tumours have an obvious malignant potential and a very poor prognosis when invasive carcinoma has developed. Early recognition and resection are the cornerstones of treatment.
authors.affiliation: Department of Medico-Surgical Hepato-Gastroenterology, Université Libre de Bruxelles, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Azar
authors.forename: J
authors.initials: J
authors.lastname: Van de Stadt
authors.forename: F
authors.initials: F
authors.lastname: Rickaert
authors.forename: M
authors.initials: M
authors.lastname: Devière
authors.forename: M
authors.initials: M
authors.lastname: Baize
authors.forename: G
authors.initials: G
authors.lastname: Klöppel
authors.forename: M
authors.initials: M
authors.lastname: Gelin
authors.forename: M
authors.initials: M
authors.lastname: Cremer
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D018291:Cystadenoma, Mucinous / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D010195:Pancreatitis / Q000209:etiology; D015996:Survival Rate; D016896:Treatment Outcome