Brief Reports
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2005; 11(36): 5688-5690
Published online Sep 28, 2005. doi: 10.3748/wjg.v11.i36.5688
Malignancies associated with intraductal papillary mucinous neoplasm of the pancreas
Terumi Kamisawa, Yuyang Tu, Naoto Egawa, Hitoshi Nakajima, Kouji Tsuruta, Atsutake Okamoto
Terumi Kamisawa, Yuyang Tu, Naoto Egawa, Hitoshi Nakajima, Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
Kouji Tsuruta, Atsutake Okamoto, Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Terumi Kamisawa, Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan. kamisawa@cick.jp
Telephone: +81-3-3823-2101 Fax: +81-3-3824-1552
Received: March 12, 2004
Revised: April 1, 2005
Accepted: April 2, 2005
Published online: September 28, 2005
Abstract

AIM: As intraductal papillary mucinous neoplasm (IPMN) has a favorable prognosis, associated malignancies have potential significance in these patients. We examined the incidence and characteristics of pre-existing, coexisting and subsequent malignancies in patients with IPMN.

METHODS: Seventy-nine cases of IPMN were diagnosed by detection of mucous in the pancreatic duct during endoscopic retrograde pancreatography. Histological diagnosis was confirmed in 30 cases (adenoma (n = 19) and adenocarcinoma (n = 11). Other primary malignancies associated with IPMN, occurring in the prediagnostic or postdiagnostic period, were investigated. Postdiagnostic follow-up period was 3.3 ± 0.5 years (range, 0.2-20 years).

RESULTS: Other 40 malignancies occurred in 28 patients (35%). They were found before (n = 15), at (n = 19) and after (n = 6) the diagnosis of IPMT. Major associated malignancies were gastric cancer (n = 12), colonic cancer (n = 7), esophageal cancer (n = 4), pulmonary cancer (n = 4), and independent pancreatic cancer (n = 3). Pancreatic cancer was synchronous with IPMN in two patients and metachronous in one (3 years after diagnosis of IPMN). Thirty-one lesions were treated surgically or endoscopically. Fourteen patients died of associated cancers. Development of other malignancies was related to age (71.9 ± 8.2 vs 66.8 ± 9.3, P < 0.05), but not to gender or site of the tumor.

CONCLUSION: IPMN is associated with a high incidence of other malignancies, particularly gastric and colonic cancers. Common genetic mechanisms between IPMN and other associated malignancies might be present. Clinicians should pay attention to the possibility of associated malignancies in preoperative screening and follow-up of patients with IPMN.

Keywords: Intraductal papillary mucinous neoplasms; Pancreas; Gastric cancer; Colonic cancer