title: Incidence of synchronous and metachronous pancreatic carcinoma in 168 patients with branch duct intraductal papillary mucinous neoplasm.
abstract: OBJECTIVE
  Although branch duct intraductal papillary mucinous neoplasms of the pancreas (BD-IPMN) are being diagnosed with increasing frequency, the incidence of concomitant pancreatic carcinoma (PC) is not well known. We investigated the incidence and clinical features of synchronous and metachronous PC in patients with BD-IPMN.
  
  
  METHODS
  We studied 168 BD-IPMN patients diagnosed by various imaging modalities, including endoscopic retrograde pancreatography, between 1990 and 2008. We reviewed the medical records and clinical features in both patients developing and not developing PC. The diagnosis of PC was histologically verified in all patients.
  
  
  RESULTS
  PC was observed in 9 (5.4%) of 168 patients. Five were synchronously detected at the time of BD-IPMN diagnosis, whereas four were metachronously identified during the follow-up period. All PCs occurred in regions separate from the BD-IPMN lesion. All PCs represented histologically invasive ductal adenocarcinomas, whereas the BD-IPMN lesion was diagnosed as adenoma. Patients developing PC were significantly older than patients not developing PC (p = 0.017). The diameters of the BD-IPMN lesions and main pancreatic ducts were significantly smaller in patients developing PC than patients not developing PC (p = 0.013 and p < 0.001, respectively).
  
  
  CONCLUSIONS
  It was not infrequent for PC to occur in the pancreas with BD-IPMN. Particular attention should therefore be paid to the development of PC, even in low-risk BD-IPMN, as well as to changes in BD-IPMN.
authors.affiliation: Department of General Medicine, Asahikawa Medical College, Asahikawa, Japan. tanno1se@asahikawa-med.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanno
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakano
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Sugiyama
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Nakamura
authors.forename: Junpei
authors.initials: J
authors.lastname: Sasajima
authors.forename: Kazuya
authors.initials: K
authors.lastname: Koizumi
authors.forename: Madoka
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Tomoya
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Mizukami
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yanagawa
authors.forename: Tsuneshi
authors.initials: T
authors.lastname: Fujii
authors.forename: Takeshi
authors.initials: T
authors.lastname: Obara
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Okumura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies