Mucinous Intrapapillary Neoplasm Of The Pancreas. Case Report
Main Article Content
Keywords
intrapapillary, neoplasia, mucinous, pancreas
Abstract
Introduction: Mucinous intrapapillary neoplasia of the pancreas was first described in 1980. Its incidental diagnosis in routine cross-sectional imaging studies has increased. Branched duct intraductal papillary mucinous neoplasms (BD-IPMN) are the most common cystic lesions encountered in practice and carry a low, but not insignificant, risk of developing cancer in the long term. Most lesions are asymptomatic and benign, but some lesions carry a significant risk of malignant transformation, so proper identification of these lesions is critical.
Objective: Develop the case report of a patient with mucinous intrapapillary neoplasia of the pancreas.
Methodology: A clinical case of a 51-year-old female who was admitted to the emergency room due to severe abdominal pain is reported, an imaging study was performed in which a mass with a diagnosis suggestive of IPNM was visualized, a splenopancreaticoduodenectomy was performed, which presented complications, for which is converted to laparotomy, a histopathologic diagnosis of IPNM is provided.
Conclusions: IPNM is characterized by a mass with an abundant amount of mucinous material, its progression is slow, its diagnosis is usually incidental when performing imaging studies, it presents a cancerous tendency with an average of 5 years, its therapy must be radical surgery to avoid recurrences, which occur in 60-70% of patients with tail and body of residual pancreas.
References
2. Nasca V, Chiaravalli M, Piro G, Esposito A, Salvatore L, Tortora G, et al. Intraductal Pancreatic Mucinous Neoplasms: A Tumor-Biology Based Approach for Risk Stratification. Int J Mol Sci. 2 de septiembre de 2020;21(17):E6386.
3. Hecht EM, Khatri G, Morgan D, Kang S, Bhosale PR, Francis IR, et al. Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: recommendations for Standardized Imaging and Reporting from the Society of Abdominal Radiology IPMN disease focused panel. Abdom Radiol (NY). abril de 2021;46(4):1586-606.
4. Konaktchieva M, Penchev D, Popivanov G, Vladova L, Cirocchi R, Penkov M, et al. Intraductal Papillary Mucinous Neoplasm of the Pancreas: Need for a Tailored Approach to a Rare Entity. Folia Medica. 2021 Dec 31;63(6):970-6.
5. Capurso G, Crippa S, Vanella G, Traini M, Zerboni G, Zaccari P, et al. Factors Associated With the Risk of Progression of Low-Risk Branch-Duct Intraductal Papillary Mucinous Neoplasms. JAMA Netw Open. 2 de noviembre de 2020;3(11):e2022933.
6. Fritz S, Küper-Steffen R, Feilhauer K, Sommer CM, Richter GM, Bosse A, et al. Intraductal tubular papillary neoplasm (ITPN), a novel entity of pancreatic epithelial neoplasms and precursor of cancer: A case report and review of the literature. International Journal of Surgery Case Reports. 1 de enero de 2019;55:187-91.
7. Polk SL, Choi JW, McGettigan MJ, Rose T, Ahmed A, Kim J, et al. Multiphase computed tomography radiomics of pancreatic intraductal papillary mucinous neoplasms to predict malignancy. World Journal of Gastroenterology. 28 de junio de 2020;26(24):3458-71.
8. Kim H, Ro JY. Intraductal Tubulopapillary Neoplasm of the Pancreas: An Overview. Archives of Pathology & Laboratory Medicine. 1 de marzo de 2018;142(3):420-3.
9. Pozo-Palacios J, García-Díaz G, Cruz F, Porras F, Heras J, Cano-Pérez E. Spatial Distribution of Congenital Disorders Diagnosed by the Newborn Screening Program in Ecuador. J inborn errorsmetab screen [Internet]. July 9, 2021 [cited October 24, 2022];9. Available in: http://www.scielo.br/j/jiems/a/PRBf646MVxP48V7qVYRwVzb/?lang=en
10. Pozzi Mucelli RM, Moro CF, Del Chiaro M, Valente R, Blomqvist L, Papanikolaou N, et al. Branch-duct intraductal papillary mucinous neoplasm (IPMN): Are cyst volumetry and other novel imaging features able to improve malignancy prediction compared to well-established resection criteria? Eur Radiol. agosto de 2022;32(8):5144-55.
11. Inomata K, Kitago M, Obara H, Fujii-Nishimura Y, Shinoda M, Yagi H, et al. Concurrent presentation of an intraductal tubulopapillary neoplasm and intraductal papillary mucinous neoplasm in the branch duct of the pancreas, with a superior mesenteric artery aneurysm: a case report. World Journal of Surgical Oncology. 24 de abril de 2018;16(1):83.
12. Luu AM, Lutz T, Uhl W, Braumann C. Pancreaticogastric Fistula Due to Infiltration of a Mixed Type Intrapapillary Mucinous Neoplasia of the Pancreas. J Gastrointest Surg. 1 Feb 2019;23(2):379-80.
13. Yamashita S, Ikemoto T, Morine Y, Imura S, Iwahashi S, Saito Y, et al. Two cases of non-mucinous cystadenomas of the pancreas with pancreatobiliary phenotype and ovarian-like stroma. Surgical Case Reports. 23 de julio de 2019;5(1):117.
14. Hirono S, Yamaue H. Surgical strategy for intraductal papillary mucinous neoplasms of the pancreas. Surg Today. enero de 2020;50(1):50-5.
15. Trinh VQH, Roland JT, Wong J, Revetta F, Patel K, Shi C, et al. Peak density of immature nerve cells occurs with high-grade dysplasia in intraductal papillary mucinous neoplasms of the pancreas. The Journal of Pathology. 2022;258(1):69-82.