Oh Seok Jin, Lee Se Joon, Lee Hwal Youn, Paik Yong Han, Lee Dong Ki, Lee Kwan Sik, Chung Jae Bock, Yu Jeong Sik, Yoon Dong Sup
Departments of Internal Medicine,Yonsei University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2009 Sep;54(3):162-6. doi: 10.4166/kjg.2009.54.3.162.
BACKGROUND/AIMS: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas has a favorable prognosis, but seems to be associated with a high incidence of extrapancreatic tumors. The purpose of this study was to evaluate the incidence and clinicopathological features of extrapancreatic tumors associated with IPMN.
Thirty-seven patients with IPMN of the pancreas, confirmed by surgical resection and typical findings of endoscopic ultrasonography and CT imaging between October 1, 1998 and August 31, 2006 were included. Seventeen patients were diagnosed with surgical resection and biopsy, and others by typical imaging findings of IPMN. These patients were examined for the development of extrapancreatic tumors.
Of 37 patients with IPMN, 14 (38%) had 18 extrapancreatic tumors, and 10 (27%) had 13 extrapancreatic malignancies. Five, six, and two extrapancreatic malignancies had been diagnosed before, during, and after the diagnosis of IPMN. Gastric adenocarcinoma (3 patients, 23%) and colorectal carcinoma (3 patients, 23%) were the most common neoplasms. Other extrapancreatic tumors included lung cancer (n=2), prostatic cancer (n=1), renal cell carcinoma (n=1), cholangiocellular carcinoma (n=1), urinary bladder cancer (n=1), and gallbladder cancer (n=1), respectively. As benign tumor, there were two gallbladder adenoma, one gastric adenoma, one colonic adenoma and one benign ovarian cystic neoplasm, respectively.
IPMN is associated with high incidence of extrapancreatic tumors, particularly gastric and colorectal neoplasms. Upper gastrointestinal endoscopy and colonoscopy should be done, and systemic surveillance for the possible occurrence of other tumors may allow early detection of extrapancreatic tumor in patients with IPMN.
背景/目的：胰腺导管内乳头状黏液性肿瘤（IPMN）预后良好，但似乎与胰腺外肿瘤的高发病率相关。本研究的目的是评估与IPMN相关的胰腺外肿瘤的发病率及临床病理特征。
纳入1998年10月1日至2006年8月31日期间经手术切除及内镜超声和CT成像典型表现确诊为胰腺IPMN的37例患者。17例患者经手术切除及活检确诊，其他患者通过IPMN的典型影像学表现确诊。对这些患者进行胰腺外肿瘤发生情况的检查。
37例IPMN患者中，14例（38%）有18个胰腺外肿瘤，10例（27%）有13个胰腺外恶性肿瘤。5例、6例和2例胰腺外恶性肿瘤分别在IPMN诊断之前、诊断期间和诊断之后被确诊。胃腺癌（3例，23%）和结直肠癌（3例，23%）是最常见的肿瘤。其他胰腺外肿瘤分别包括肺癌（n = 2）、前列腺癌（n = 1）、肾细胞癌（n = 1）、胆管细胞癌（n = 1）、膀胱癌（n = 1）和胆囊癌（n = 1）。作为良性肿瘤，分别有2例胆囊腺瘤、1例胃腺瘤、1例结肠腺瘤和1例良性卵巢囊性肿瘤。
IPMN与胰腺外肿瘤的高发病率相关，尤其是胃和结肠肿瘤。应进行上消化道内镜检查和结肠镜检查，对可能发生的其他肿瘤进行系统监测，可能有助于早期发现IPMN患者的胰腺外肿瘤。
