High incidence of extrapancreatic neoplasms in patients with intraductal papillary mucinous neoplasms.
BACKGROUND
Intraductal papillary mucinous neoplasms (IPMNs) are associated with a high incidence of extrapancreatic neoplasms.


METHODS
Retrospective study.


METHODS
Tertiary care referral center.


METHODS
Sixty-one patients underwent surgical resection for IPMN between January 1, 1993, and June 30, 2004. Thirty-eight patients with mucinous cystic neoplasms and 50 patients with pancreatic ductal adenocarcinoma also were examined for development of extrapancreatic neoplasms.


METHODS
The incidence and clinicopathological features of extrapancreatic neoplasms with IPMNs were compared with those with mucinous cystic neoplasm and pancreatic ductal adenocarcinoma.


RESULTS
Of the 61 patients with IPMNs, 24 (39%) developed 26 extrapancreatic neoplasms, and 18 (30%) had extrapancreatic malignancies. Gastric adenocarcinoma (33%) and colorectal adenocarcinoma (17%) were the most common neoplasms in the 24 patients. During postoperative follow-up, 3 patients died of malignant IPMNs, 3 of associated malignancies, and 1 of a nonmalignancy-related cause. Comparisons of the clinicopathological features in patients with IPMNs with and without associated malignancies revealed no significant differences in age, sex, family history of malignancy, history of cigarette smoking or alcohol abuse, or type of IPMN. The incidence of extrapancreatic neoplasms in patients with IPMN was significantly higher than in those with other pancreatic diseases such as mucinous cystic neoplasm (8%) or pancreatic ductal adenocarcinoma (10%).


CONCLUSIONS
Frequently, IPMNs are associated with the development of extrapancreatic neoplasms. Considerable attention should be paid to the possible occurrence of other associated malignancies in patients with IPMNs, either concurrently or postoperatively. Further molecular studies may be necessary to elucidate the unusual association between IPMN and other primary neoplasms.
Choi
Min-Gew
MG
Department of Surgery, Seoul National University College of Medicine, 20 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea.
Kim
Sun-Whe
SW
Han
Sung-Sik
SS
Jang
Jin-Young
JY
Park
Yong-Hyun
YH
D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology; D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000453:epidemiology*; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000453:epidemiology*; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000453:epidemiology*