title: Recurrence of non-invasive intraductal papillary municious neoplasm seven years following total pancreatectomy.
abstract: BACKGROUND
  Intraductal papillary mucinous neoplasm is an increasingly recognized disease with varying premalignant potential and unclear incidence, characterized by a mucin-producing epithelium and dilation of the pancreatic duct.
  
  
  METHODS
  We present the first documented case of distant intestinal intraductal papillary mucinous neoplasm recurrence following total pancreatectomy for side-branch non-invasive borderline malignant intraductal papillary mucinous neoplasm.
  
  
  CONCLUSIONS
  We review the current literature in order to try and answer important questions regarding our ability to predict intraductal papillary mucinous neoplasm recurrence, our understanding of the potential for recurrence and what follow-up should be recommended to properly monitor recurrence after a benign, albeit borderline malignant, side-branch lesion resection.
  
  
  CONCLUSIONS
  Our case report confirms that the low risk classification of an intraductal papillary mucinous neoplasm lesion even after total pancreatectomy does not always predict recurrence and that definitive prognostic factors of recurrence in the setting of non-invasive disease have yet to be identified. A vigilant long-term approach to follow-up may thus be required even in low risk cases.
authors.affiliation: Resident in Internal Medicine, Sherbrooke University, 12125 Desencalves, Montreal, QC, Canada H3M 2W2. Electronic address: nayima.c@gmail.com.
authors.forename: Nayima M Clermont
authors.initials: NM
authors.lastname: Dejean
authors.forename: Sinziana
authors.initials: S
authors.lastname: Dumitra
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Barkun
keywords: EUS; IPMN; MRCP; Management; Neoplasm; Pancreas; Pancreatectomy; Recurrence; endoscopic ultrasound; intraductal papillary mucinous neoplasm; magnetic resonance cholangiopancreatography
references.citation: Virchows Arch. 2007 Nov;451(5):863-9
references.pmid: 17899180
references.citation: World J Gastrointest Surg. 2010 Oct 27;2(10):324-30
references.pmid: 21160838
references.citation: J Hepatobiliary Pancreat Surg. 2008;15(2):183-8
references.pmid: 18392712
references.citation: Ann Surg Oncol. 2006 Apr;13(4):582-94
references.pmid: 16523362
references.citation: Gastroenterology. 2007 Jul;133(1):72-9; quiz 309-10
references.pmid: 17631133
references.citation: Surgeon. 2005 Oct;3(5):317-24
references.pmid: 16245650
references.citation: Gastroenterology. 2002 Nov;123(5):1500-7
references.pmid: 12404225
references.citation: Clin Gastroenterol Hepatol. 2008 Jul;6(7):815-9; quiz 719
references.pmid: 18602036
references.citation: HPB (Oxford). 2009 Sep;11(6):483-92
references.pmid: 19816612
references.citation: Ann Surg. 2010 Jan;251(1):64-9
references.pmid: 19858708
references.citation: Am J Surg. 2008 Nov;196(5):e50-2
references.pmid: 18513697
references.citation: Pancreas. 2012 Jan;41(1):137-41
references.pmid: 22076564
references.citation: Ann Surg. 2004 Jun;239(6):788-97; discussion 797-9
references.pmid: 15166958
references.citation: Nat Rev Gastroenterol Hepatol. 2011 Jan;8(1):56-60
references.pmid: 21212775
references.citation: J Gastrointest Surg. 2008 Apr;12(4):645-50
references.pmid: 18097728
references.citation: Ann Surg. 2007 Dec;246(6):932-7; discussion 937-9
references.pmid: 18043094
references.citation: World J Gastrointest Surg. 2010 Oct 27;2(10):342-6
references.pmid: 21160841
references.citation: Arch Surg. 2008 Jul;143(7):639-46; discussion 646
references.pmid: 18645105
references.citation: J Am Coll Surg. 2007 May;204(5):987-93; discussion 993-5
references.pmid: 17481526
references.citation: Dig Liver Dis. 2012 Mar;44(3):257-60
references.pmid: 22030480
references.citation: World J Gastrointest Endosc. 2010 Oct 16;2(10):349-51
references.pmid: 21160585
references.citation: Eur J Gastroenterol Hepatol. 2010 Sep;22(9):1029-38
references.pmid: 20520560
references.citation: Am J Surg. 2005 May;189(5):632-6; discussion 637
references.pmid: 15862510
references.citation: Pancreatology. 2006;6(1-2):17-32
references.pmid: 16327281
references.citation: Br J Surg. 2001 Mar;88(3):376-81
references.pmid: 11260102