[Intraductal papillary mucinous tumors of the pancreas: diagnostic and therapeutic approach].
OBJECTIVE
Literature review of the diagnostic and therapeutic approach to intraductal papillary mucinous tumors of the pancreas and report of a new case.


METHODS
We present the case of an 85-year-old man treated in our center for steatorrhea and weight loss. Abdominal computerized tomography (CT) showed a heterogeneous pancreatic mass, affecting the hilus, surrounding the superior mesenteric artery and producing dilatation of the biliary tract. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a polypoid neoformation in the lower part of the duodenum and leakage of mucus through the papilla. Biopsy revealed pancreatic adenoma.


CONCLUSIONS
Intraductal papillary mucinous tumor of the pancreas is potentially curable with an uncertain prognosis. Correct diagnosis is required for optimal treatment. One of the greatest problems in this entity continues to be the difficulty of predicting the presence of an infiltrating component, which significantly worsens prognosis. The various diagnostic methods used are abdominal CT, echoendoscopy, ERCP, endoscopy of the Wirsung duct, intraoperative ultrasonography and study of the intraoperative pancreatic resection margin. Treatment requires complete resection of the lesion, although if this provokes pancreatic failure, only tumors with invasive components should be extirpated.
Fernández de Bobadilla Olazábal
L
L
Departamento de Cirugía General y Digestivo del Hospital Ramón y Cajal. Madrid. España.
Díe
J
J
Martínez Molina
E
E
Sanjuambenito
A
A
Fernández Merino
J
J
Losa
N
N
Mena
A
A
Aguilera
A
A
Fresneda
V
V
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000601:surgery*; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D014057:Tomography, X-Ray Computed