Incidence of synchronous and metachronous pancreatic carcinoma in 168 patients with branch duct intraductal papillary mucinous neoplasm.
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.
Tanno
Satoshi
S
Department of General Medicine, Asahikawa Medical College, Asahikawa, Japan. tanno1se@asahikawa-med.ac.jp
Nakano
Yasuhiro
Y
Sugiyama
Yoshiaki
Y
Nakamura
Kazumasa
K
Sasajima
Junpei
J
Koizumi
Kazuya
K
Yamazaki
Madoka
M
Nishikawa
Tomoya
T
Mizukami
Yusuke
Y
Yanagawa
Nobuyuki
N
Fujii
Tsuneshi
T
Obara
Takeshi
T
Okumura
Toshikatsu
T
Kohgo
Yutaka
Y
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