Navarro Colás Salvador, Vaquero Raya Eva C
Servicio de Gastroenterología, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Institut d'Investigació Biomèdica August Pí i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad de Barcelona, Barcelona, España.
Gastroenterol Hepatol. 2012 Nov;35(9):652-9. doi: 10.1016/j.gastrohep.2012.05.009. Epub 2012 Jul 24.
Intraductal papillary mucinous neoplasm (IPMN) is a premalignant pancreatic entity characterized by papillary growth of the ductal epithelium with rich mucin production and cystic dilatation of the main pancreatic duct and/or its branches. These neoplasms are often multifocal. Preoperative distinction between benign and malignant lesions is important to select the most appropriate treatment and to improve prognosis. Early surgical resection is the treatment of choice to avoid malignant transformation when predictive factors for malignancy are present. These factors include localization, cyst greater than 3cm, nodules in the cystic wall, atypias in the cyst fluid and the presence of symptoms. The extent of resection required for adequate treatment of IPMN of the pancreas is still controversial. Patients who retain a portion of their pancreas following resection of an IPMN need to be followed up with periodic imaging to detect recurrences, signs indicating a risk of malignant transformation, and metachronous lesions. The existence of possible synchronous or metachronous lesions in other organs should also be investigated.
导管内乳头状黏液性肿瘤（IPMN）是一种胰腺癌前病变，其特征为导管上皮呈乳头状生长，伴有丰富的黏液分泌，以及主胰管和/或其分支的囊性扩张。这些肿瘤通常为多灶性。术前区分良性和恶性病变对于选择最合适的治疗方法和改善预后非常重要。当存在恶性预测因素时，早期手术切除是避免恶性转化的首选治疗方法。这些因素包括肿瘤位置、囊肿大于3cm、囊壁结节、囊液异型性以及症状的存在。胰腺IPMN充分治疗所需的切除范围仍存在争议。IPMN切除术后保留部分胰腺的患者需要定期进行影像学检查随访，以检测复发、提示恶性转化风险的体征以及异时性病变。还应调查其他器官中可能存在的同步或异时性病变。
