Original communicationIntraductal papillary-mucinous neoplasms and mucinous cystic neoplasms of the pancreas differentiated by ovarian-type stroma
Section snippets
Patients and methods
Patients. Medical records were reviewed retrospectively for 77 patients with pancreatic cystic neoplasm with mucin secretion who were treated at the Department of Surgery, Hiroshima University Hospital, between June 1990 and September 2004. All patients underwent resection of these neoplasms and had a confirmed pathologic diagnosis. Preoperatively, all patients underwent transabdominal ultrasonography and computed tomography. Some patients also underwent endoscopic ultrasonography (EUS, 70
Results
Preoperative characteristics. Among the 70 patients with IPMN were 53 men and 17 women; all 7 patients with MCN were women. MCN patients were younger (P < .001) than IPMN patients. IPMN was located more frequently in the head of the pancreas (76%), while MCN was found in the body and tail of the pancreas in 6 of 7 patients. One patient with MCN arising from the pancreatic head was reported previously.18 Preoperative serum levels of carcinoembryonic antigen and carbohydrate antigen 19-9 did not
Discussion
Many patients with cystic neoplasms called MCNs without ovarian-type stroma have been reported in the literature8, 19, 20 because classification and definition of pancreatic cystic neoplasms with mucin secretion have been unclear. The working group of the Japan Pancreas Society proposed new diagnostic criteria for IPMN and MCN, and performed a multi-institutional, retrospective study of IPMN and MCN in accordance with the new criteria to analyze clinicopathologic features of these neoplasms.8
Conclusion
The clinicopathologic differences between IPMN and MCN become much clearer after differentiation between neoplasm types according to the presence of ovarian-type stroma in the neoplasm. A favorable prognosis is predicted for both neoplasms if they are completely resected before they have progressed to invasive carcinoma.
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