title: Intraductal papillary mucinous neoplasm: did it exist prior to 1980?
abstract: BACKGROUND
  Intraductal papillary mucinous neoplasm (IPMN) of the pancreas was first reported in 1982. It is not clear whether the appearance of this neoplasm is a new epidemic or an old disease previously overlooked.
  
  
  OBJECTIVE
  To determine whether IPMN existed as a separate entity before 1982.
  
  
  METHODS
  We reviewed our pathology reports from all cases of pancreatic cancer diagnosed between 1960 and 1980. Pathologic specimens with descriptors--"mucinous," "cystic," or "papillary"--underwent histologic reexamination. Medical records for patients given a new diagnosis of IPMN from this pathologic review were assessed.
  
  
  RESULTS
  Eighty-four of more than 4,000 pathology reports reviewed contained a key word triggering histologic review. IPMN was identified in 21 patients. Patients had a mean age of 63 years (range, 44-77 years) with symptoms present for a mean of 76 months (median, 15 months; range, 1-516 months). Reported symptoms were abdominal pain in 17, jaundice in 13, weight loss in 12, and pancreatic insufficiency in 7 patients. On pathologic review, the in situ component was graded as adenoma in 4, borderline in 4, and carcinoma in 13. Parenchymal invasion was present in 11/21 (52%). Excluding four postoperative mortalities, mean time to death was 58 months (median, 15 months; range, 2-264 months). Seven patients died of IPMN, 4 of other causes without evidence of recurrence, and 6 of unknown causes.
  
  
  CONCLUSIONS
  IPMN existed in its current known form prior to 1982. Our study cannot determine whether the prevalence or incidence has changed since that time.
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Tollefson
authors.forename: Karen D
authors.initials: KD
authors.lastname: Libsch
authors.forename: Michael G
authors.initials: MG
authors.lastname: Sarr
authors.forename: Suresh T
authors.initials: ST
authors.lastname: Chari
authors.forename: Eugene P
authors.initials: EP
authors.lastname: DiMagno
authors.forename: Raul
authors.initials: R
authors.lastname: Urrutia
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Smyrk
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D000328:Adult; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D016019:Survival Analysis