title: Clinicopathological features of patients with concomitant intraductal papillary mucinous neoplasm of the pancreas and pancreatic endocrine neoplasm.
abstract: OBJECTIVE
  The occurrence of concomitant pancreatic endocrine neoplasm (PEN) and intraductal papillary neoplasm (IPMN) of the pancreas has rarely been reported. We describe our experience with 3 patients with this association and review the existing literature.
  
  
  METHODS
  From 1990 to 2005, 65 patients who underwent surgery for a PEN or IPMN were retrospectively reviewed. Forty-three patients had a PEN, 19 had an IPMN and 3 had both an IPMN and PEN. The 3 patients with concomitant IPMN and PEN are the focus of the current study and their clinicopathological features are reported together with 7 patients previously reported in the literature.
  
  
  RESULTS
  There were 10 patients with a median age of 62 years (range 40-73). The male:female ratio was equal. Seven of 10 patients were symptomatic and the most common symptoms were abdominal pain (n = 5), jaundice (n = 2) and loss of weight (n = 2). The median size of the endocrine neoplasms was 14 mm (range 2-30) and they occurred in the head (n = 3), body (n = 2) and tail (n = 5). Seven of the PENs were classified as benign, 2 were potentially malignant, and 1 was frankly malignant with lymph node involvement. None of the endocrine neoplasms were functioning. The IPMNs were found in the tail (n = 4), head (n = 3), head and body (n = 1), body (n = 1) and the entire pancreas (n = 1). Five of these neoplasms were benign, 2 were borderline and 3 were malignant (1 carcinoma in situ).
  
  
  CONCLUSIONS
  The occurrence of concomitant IPMN and PEN is more frequent than would be expected. However, it is difficult in the present analysis to determine if this association is more than just fortuitous.
authors.affiliation: Department of Surgery, Singapore General Hospital, Singapore, Singapore.
authors.forename: Brian K P
authors.initials: BK
authors.lastname: Goh
authors.forename: London L P J
authors.initials: LL
authors.lastname: Ooi
authors.forename: Marian Priyanthi
authors.initials: MP
authors.lastname: Kumarasinghe
authors.forename: Yu-Meng
authors.initials: YM
authors.lastname: Tan
authors.forename: Peng-Chung
authors.initials: PC
authors.lastname: Cheow
authors.forename: Pierce K H
authors.initials: PK
authors.lastname: Chow
authors.forename: Yaw-Fui Alexander
authors.initials: YF
authors.lastname: Chung
authors.forename: Wai-Keong
authors.initials: WK
authors.lastname: Wong
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D018278:Carcinoma, Neuroendocrine / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D021441:Carcinoma, Pancreatic Ductal / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D002864:Chromogranins / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D016708:Synaptophysin / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D002864:Chromogranins; D016708:Synaptophysin