title: Malignancies associated with intraductal papillary mucinous neoplasm of the pancreas.
abstract: OBJECTIVE
  As intraductal papillary mucinous neoplasm (IPMN) has a favorable prognosis, associated malignancies have potential significance in these patients. We examined the incidence and characteristics of pre-existing, coexisting and subsequent malignancies in patients with IPMN.
  
  
  METHODS
  Seventy-nine cases of IPMN were diagnosed by detection of mucous in the pancreatic duct during endoscopic retrograde pancreatography. Histological diagnosis was confirmed in 30 cases (adenoma (n = 19) and adenocarcinoma (n = 11). Other primary malignancies associated with IPMN, occurring in the prediagnostic or postdiagnostic period, were investigated. Postdiagnostic follow-up period was 3.3+/-0.5 years (range, 0.2-20 years).
  
  
  RESULTS
  Other 40 malignancies occurred in 28 patients (35%). They were found before (n = 15), at (n = 19) and after (n = 6) the diagnosis of IPMT. Major associated malignancies were gastric cancer (n = 12), colonic cancer (n = 7), esophageal cancer (n = 4), pulmonary cancer (n = 4), and independent pancreatic cancer (n = 3). Pancreatic cancer was synchronous with IPMN in two patients and metachronous in one (3 years after diagnosis of IPMN). Thirty-one lesions were treated surgically or endoscopically. Fourteen patients died of associated cancers. Development of other malignancies was related to age (71.9+/-8.2 vs 66.8+/-9.3, P<0.05), but not to gender or site of the tumor.
  
  
  CONCLUSIONS
  IPMN is associated with a high incidence of other malignancies, particularly gastric and colonic cancers. Common genetic mechanisms between IPMN and other associated malignancies might be present. Clinicians should pay attention to the possibility of associated malignancies in preoperative screening and follow-up of patients with IPMN.
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Tokyo 113-8677, Japan. kamisawa@cick.jp
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Yuyang
authors.initials: Y
authors.lastname: Tu
authors.forename: Naoto
authors.initials: N
authors.lastname: Egawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Kouji
authors.initials: K
authors.lastname: Tsuruta
authors.forename: Atsutake
authors.initials: A
authors.lastname: Okamoto
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000150:complications*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications*; D003110:Colonic Neoplasms / Q000150:complications* / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000150:complications* / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000150:complications / Q000453:epidemiology