Mucin-producing neoplasms of the pancreas: an analysis of distinguishing clinical and epidemiologic characteristics.
OBJECTIVE
Mucin-producing neoplasms (MPNs) of the pancreas include mucinous cystic neoplasms (MCNs) and main-duct, branch-duct, and combined intraductal papillary mucinous neoplasms (IPMNs). MCNs and branch-duct IPMNs are frequently confused; it is unclear whether main-duct, combined, and branch-duct IPMNs are a different spectrum of the same disease. We evaluated their clinical and epidemiologic characteristics.


METHODS
Patients who underwent resection for histologically confirmed MPNs were identified (N = 557); specimens were reviewed and eventually reclassified.


RESULTS
One hundred sixty-eight patients (30%) had MCNs, 159 (28.5%) had branch-duct IPMNs, 149 (27%) had combined IPMNs, and 81 (14.5%) had main-duct IPMNs. Patients with MCNs were significantly younger and almost exclusively women; 44% of patients with main-duct or combined IPMNs and 57% of those with branch-duct IPMNs were women. MCNs were single lesions located in the distal pancreas (95%); 11% were invasive. IPMNs were more frequently found in the proximal pancreas; invasive cancer was found in 11%, 42%, and 48% of branch-duct, combined, and main-duct IPMNs, respectively (P = .001). Patients with invasive MCN and those with combined and main-duct IPMNs were older than those with noninvasive tumors. The 5-year disease-specific survival rate approached 100% for patients with noninvasive MPNs. The rates for those with invasive cancer were 58%, 56%, 51%, and 64% for invasive MCNs, branch-duct IPMNs, main-duct IPMNs, and combined IPMNs, respectively.


CONCLUSIONS
MPNs comprise 3 different neoplasms: MCNs, branch-duct IPMNs, and main-duct IPMNs, including the combined type. These tumors have specific clinical, epidemiologic, and morphologic features that allow a reasonable degree of accuracy in preoperative diagnosis.
Crippa
Stefano
S
Department of Surgery, Policlinico GB Rossi, University of Verona, Verona, Italy.
Fernández-Del Castillo
Carlos
C
Salvia
Roberto
R
Finkelstein
Dianne
D
Bassi
Claudio
C
Domínguez
Ismael
I
Muzikansky
Alona
A
Thayer
Sarah P
SP
Falconi
Massimo
M
Mino-Kenudson
Mari
M
Capelli
Paola
P
Lauwers
Gregory Y
GY
Partelli
Stefano
S
Pederzoli
Paolo
P
Warshaw
Andrew L
AL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism*; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000453:epidemiology* / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000473:pathology*
D009077:Mucins