Invasive carcinoma derived from "flat type" branch duct intraductal papillary mucinous neoplasms of the pancreas: Impact of classification according to the height of mural nodule on endoscopic ultrasonography

Shinsuke Koshita, Naotaka Fujita, Yutaka Noda, Go Kobayashi, Kei Ito, Jun Horaguchi, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yousuke Michikawa, Yuji Iwashita, Takashi Sawai, Miwa Uzuki, Fumiyoshi Fujishima

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

Background It has been reported that many branch duct intraductal papillary mucinous neoplasms (BD-IPMN) with a mural nodule (MN) reveal adenocarcinomas. On the other hand, invasive cancer derived from BD-IPMN without MN on endoscopic ultrasound (EUS) also exists. The aim of this study was to elucidate the clinicopathological features of invasive cancer derived from BD-IPMN without MN on EUS. Methods Twenty-one patients pathologically diagnosed with invasive cancer derived from BD-IPMN were included in this study. Results Based on the height of MNs on EUS, the subjects could be clearly classified as 12 patients whose background BD-IPMNs had high MNs (nodule-forming type IPMN) and nine whose background BD-IPMNs showed no MNs (flat type IPMN). The background BD-IPMN of the 12 patients with nodule-forming type IPMN were non-gastric type. On the other hand, the background BD-IPMN of the nine patients with flat type IPMN was gastric type. The recurrence rate was higher (33% vs. 67%) and the 5-year survival was worse (76% vs. 33%) in flat type IPMN. Conclusions There may be a pathway for the development of invasive cancer without the formation of an MN in BD-IPMN, and attention should be paid even to the patients with BD-IPMN which does not present an MN.

Original languageEnglish
Pages (from-to)301-309
Number of pages9
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume22
Issue number4
DOIs
Publication statusPublished - 2015 Apr 1

Keywords

  • Endoscopic ultrasound
  • Flat type
  • Intraductal papillary mucinous neoplasms
  • Invasive carcinoma
  • Mural nodule

ASJC Scopus subject areas

  • Surgery
  • Hepatology

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