title: Branch-duct intraductal papillary mucinous neoplasm and embolic stroke of unknown cause.
abstract: BACKGROUND
  In many embolic strokes, the specific embolic source might be uncertain. When we found asymptomatic branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) in patients with ischemic stroke of unknown cause, most of gastroenterologists might undervalue it as a potential thromboembolic sources.
  
  
  METHODS
  We report 4 patients with embolic stroke of unknown cause and incidental BD-IPMNs.
  
  
  RESULTS
  Magnetic resonance imaging revealed multiple embolic infarctions. Recommended cardiac examinations, such as 24-hour Holter monitoring and transthoracic and transesophageal echocardiography, were normal. Other cancer markers and molecular markers of hypercoagulopathy were normal. On abdominal computed tomography scan, performed to detect hidden malignancy, a low attenuated lesion with a diameter of less than 3 cm was observed in the pancreas.
  
  
  CONCLUSIONS
  Although BD-IPMNs are associated with a lower rate of malignancy than main-duct IPMNs, the BD-IPMNs had some malignant potential and frequently coexist with extrapancreatic or intrapancreatic cancers. Therefore, we suggest that, in some cases, the BD-IPMNs might be considered as a thromboembolic source.
authors: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Yerim
authors: Y
authors: Kim
authors: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Dong-Wan
authors: DW
authors: Kang
authors: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Do Yeon
authors: DY
authors: Kim
authors: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Jung Min
authors: JM
authors: Pyun
authors: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: Sb0516@snu.ac.kr.
authors: Seung-Hoon
authors: SH
authors: Lee
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology*; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010190:Pancreatic Neoplasms / Q000473:pathology*; D020521:Stroke / Q000473:pathology*
keywords: Stroke; cerebral infarction; neoplasm; pancreas