High-Grade Dysplasia and Adenocarcinoma Are Frequent in Side-Branch Intraductal Papillary Mucinous Neoplasm Measuring Less than 3 cm on Endoscopic Ultrasound

摘要: Surgical resection for intraductal papillary mucinous neoplasm (IPMN) of the pancreas has increased over last decade. While IPMN with main duct communication are generally recommended resection, indications side-branch (SDIPMN) have been less clear. We reviewed our single institutional experience SDIPMN and resection. Patients who underwent were identified from a prospectively maintained IRB-approved database. pancreatic excluded. Outcome, clinical pathologic characteristics correlated endoscopic ultrasound (EUS) findings. From 2000 to 2010, 105 patients preoperative EUS evaluation identified. The mean age was within sixth decade life, there slight female predominance (55 vs. 45 %). most common presenting symptom abdominal pain (N = 47, 45 %), followed by jaundice (N = 24, 23 %) weight loss 23 %). Only ten (10 %) asymptomatic at presentation; seven (70 %) had suspicious features on EUS. Of total cohort, few intracystic septations (N = 27, 26 %) or presence mural nodules (N = 2, 2 %) 39 invasive ductal adenocarcinoma (PDAC) final pathology, EUS-fine needle aspiration (EUS-FNA) demonstrated malignancy in only 21 (54 %). An additional (18 %) EUS-FNA findings atypia concern neoplasm. cyst size pathology. 70 3 cm PDAC high-grade dysplasia Although overall survival (OS) 48 months stratified did not significantly differ between groups, pathology worse OS compared noninvasive A eight (8 %) developed recurrent disease, all whom is helpful modality diagnostic SDIPMN. Considering high incidence as well greater than 2 cm, should be used conjunction other criteria guide management decisions. 2 cm that do undergo surgical may benefit more intensive surveillance.