Medline ® Abstract for Reference 50
of 'Intraductal papillary mucinous neoplasm of the pancreas (IPMN): Pathophysiology and clinical manifestations'
Intraductal papillary mucinous tumors of the pancreas. Verona University Pancreatic Team.
Bassi C, Procacci C, Zamboni G, Scarpa A, Cavallini G, Pederzoli P
Int J Pancreatol. 2000;27(3):181.
METHODS: Literature is thoroughly reviewed and compared to our own experience.
RESULTS: Clinical history data do not appear to be useful in differentiating between benign and malignant cases. Usually IPMT patients are older than individuals suffering from chronic obstructive pancreatitis and tend to drink and smoke less. Malignant forms of IPMT are more frequently associated with diabetes, and pain seems to be more frequent in benign cases, although these findings are not confirmed in all reports. Also, laboratory tests are of little use, whereas imaging findings currently enable us to reach a correct diagnosis in about 70% of cases without differentiating in a reliable and definitive way the benign or malignant nature of the neoplasm. The WHO classification appears to be related to the different prognosis. Surgery, whenever possible, is the gold standard treatment.
CONCLUSION: IPMT are a recent established clinical entity embracing a spectrum of lesions ranging from benign to malignant infiltrating cases. The only recognized radical treatment is surgery. Despite diagnostic capacity based on clinical presentation and imaging techniques has becoming increasingly refined we are still incapable of identifying the different degree of malignancy preoperatively, if any. The lengthy mean survival after resection confirm the high potential cure rate of IPMT of the pancreas.
Department of Surgery-Gastroenterology, University Hospital G. B. Rossi, Verona, Italy. Bifo@Borgoroma.Univr.it