Tanno Satoshi, Sasajima Junpei, Koizumi Kazuya, Yanagawa Nobuyuki, Nakano Yasuhiro, Osanai Manabu, Mizukami Yusuke, Fujii Tsuneshi, Obara Takeshi, Okumura Toshikatsu, Kohgo Yutaka
Department of General Medicine, Asahikawa Medical College, Asahikawa, Japan.
Hepatogastroenterology. 2009 Sep-Oct;56(94-95):1545-8.
The present study reports the growth rate in two cases of main duct pancreatic intraductal papillary-mucinous neoplasms (MD-IPMNs) demonstrating significant changes over several years' observation. The first patient was a 74-year-old woman with an incidental finding of diffuse dilatation of the main pancreatic duct (MPD). Endoscopic retrograde pancreatography (ERP) identified a 5 mm filling defect. Three years later computed tomography (CT) revealed a 20 mm mass occupying the MPD. The second patient was a 67-year-old woman who presented with back pain. Abdominal CT revealed a 5 mm mass in the dilated MPD. Five years later, CT and ERP showed a 20 mm mass occupying the markedly dilated MPD. Both patients subsequently underwent pancreatectomy. Histologically, the tumors showed an intraductal papillary growth occupying the dilated MPD and comprised of mucin-containing columnar epithelial cells. The tumor volume doubling time of these MD-IPMNs was 141 and 304 days in patient 1 and 2, respectively, with a mean of 222.5 days. The present reports demonstrate the ability of benign MD-IPMNs to grow at a significant rate, supporting the current consensus guidelines that MD-IPMNs require surgical resection.
