title: Extensive multifocal branch duct IPMN of the pancreas after liver transplantation: is surgery justified?
abstract: BACKGROUND
  Cystic lesions of the pancreas resembling intraductal papillary mucinous neoplasms (IPMN) have been reported to develop in an increased rate following liver transplantation and immunosuppression. The cause for this possible association is thus far elusive.
  
  
  METHODS
  We report on a 60-year-old male patient who developed an extensive multicystic change of the entire pancreas, suspicious for IPMN, under follow-up after liver transplantation for secondary sclerosing cholangitis. A total pancreaduodenectomy with splenectomy was performed. The postoperative histopathological assessment revealed a multifocal branch duct IPMN of the gastric subtype showing low-grade dysplasia.
  
  
  CONCLUSIONS
  In the absence of evidence-based guidelines for the management of suspected IPMNs in liver transplant recipients, each patient's management should be discussed in detail.
  
  
  CONCLUSIONS
  Prospective studies may help to understand the disease and identify risk factors for malignant transformation in IPMNs after liver transplantation for treatment optimization.
authors.affiliation: Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Vittorio.branchi@ukb.uni-bonn.de.|Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Vittorio.branchi@ukb.uni-bonn.de.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Branchi
authors.affiliation: Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Philipp.lingohr@ukb.uni-bonn.de.|Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Philipp.lingohr@ukb.uni-bonn.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Lingohr
authors.affiliation: Department of Radiology, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Winfried.willinek@ukb.uni-bonn.de.|Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Winfried.willinek@ukb.uni-bonn.de.
authors.forename: Winfried A
authors.initials: WA
authors.lastname: Willinek
authors.forename: Edwin
authors.initials: E
authors.lastname: Bölke
authors.affiliation: Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Alexander.semaan@ukb.uni-bonn.de.|Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Alexander.semaan@ukb.uni-bonn.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Semaan
authors.affiliation: Institute of Pathology, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Hui.zhou@ukb.uni-bonn.de.|Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Hui.zhou@ukb.uni-bonn.de.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Institute of Pathology, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Glen.kristiansen@ukb.uni-bonn.de.|Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. Glen.kristiansen@ukb.uni-bonn.de.
authors.forename: Glen
authors.initials: G
authors.lastname: Kristiansen
authors.affiliation: Department of Pathology, Center for Pancreatic and Endocrine Tumors, Technical University Munich, Trogerstr. 18, 81675, Munich, Germany. Guenter.Kloeppel@lrz.tu-muenchen.de.
authors.forename: Günter
authors.initials: G
authors.lastname: Klöppel
authors.affiliation: Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. kalff@uni-bonn.de.|Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. kalff@uni-bonn.de.
authors.forename: Jörg C
authors.initials: JC
authors.lastname: Kalff
authors.affiliation: Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. nico.schaefer@ukb.uni-bonn.de.|Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. nico.schaefer@ukb.uni-bonn.de.
authors.forename: Nico
authors.initials: N
authors.lastname: Schäfer
authors.affiliation: Department of Surgery, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. hanno.matthaei@ukb.uni-bonn.de.|Center for Integrated Oncology (CIO) Cologne-Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. hanno.matthaei@ukb.uni-bonn.de.
authors.forename: Hanno
authors.initials: H
authors.lastname: Matthaei
mesh_terms: D006801:Humans; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery*