title: Concomitant pancreatic adenocarcinoma in a patient with branch-duct intraductal papillary mucinous neoplasm.
abstract: Branch duct intraductal papillary mucinous neoplasms (BD-IPMN) are pre-malignant pancreatic cystic lesions which carry a small risk of malignant transformation within the cyst. Guidelines exist with respect to surveillance of the cysts using computed tomography, magnetic resonance imaging, and/or endoscopic ultrasound (EUS). There are reports that patients with IPMNs are at increased risk of developing pancreatic adenocarcinoma, which arises in an area separate to the IPMNs. We present two cases of pancreatic adenocarcinoma arising within the parenchyma, distinct from the IPMN-associated cyst, identified with EUS. This case report highlights that patients with BD-IPMN are at increased risk for pancreatic adenocarcinoma separate from the cyst and also the importance for endosonographers to carefully survey the rest of the pancreatic parenchyma separate from the cyst in order to identify small pancreatic adenocarcinomas.
authors.affiliation: Joanna K Law, Christopher L Wolfgang, Matthew J Weiss, Anne Marie Lennon, Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, MD 21287, United States.
authors.forename: Joanna K
authors.initials: JK
authors.lastname: Law
authors.affiliation: Joanna K Law, Christopher L Wolfgang, Matthew J Weiss, Anne Marie Lennon, Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, MD 21287, United States.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Wolfgang
authors.affiliation: Joanna K Law, Christopher L Wolfgang, Matthew J Weiss, Anne Marie Lennon, Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, MD 21287, United States.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Weiss
authors.affiliation: Joanna K Law, Christopher L Wolfgang, Matthew J Weiss, Anne Marie Lennon, Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, MD 21287, United States.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Lennon
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000556:secondary / Q000628:therapy / Q000648:ultrastructure; D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D000231:Adenocarcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D019160:Endosonography; D006801:Humans; D033162:Incidental Findings; D008175:Lung Neoplasms / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D010166:Palliative Care; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D016577:Pancreaticoduodenectomy; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Endoscopic ultrasound; Intraductal papillary mucinous neoplasm; Pancreatic adenocarcinoma; Surveillance
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