Intraductal Papillary Mucinous Neoplasms of Pancreas- A Review - Abstract
Intraductal papillary mucinous neoplasms of pancreas are relatively common, often arise from the pancreatic head, and comprise more than one third of resected pancreatic cysts. In these lesions, the risk of dysplasia or carcinoma varies according to the site of ductal involvement or histologic subtypes. For instance, there is a higher risk of malignancy associated with main rather than branch duct IPMNs and/or with pancreaticobiliary rather than gastric subtype. Other factors altering this risk include cyst size and associated solid mural component. Although in general surgical excision is advocated for all MD-IPMNs when possible, a specific protocol is to follow for management of BD-IPMNs. Additional to specifics on the aforementioned, the present study reviews clinic-pathologic classification schema and provides recently updated guidelines on surveillance and clinical management of IPMNs. Certain molecular features and mutations such as P53 aberration have been linked to the presence of malignancy in IPMNs. Cellular/molecular techniques, newly proposed to increase the yield of diagnosis and/or potential measures of prognosis are also reported in the following review.