Clinical Features and Prognosis of Intraductal Papillary MucinousNeoplasm of the Pancreas

Intraductal papillary mucinous neoplasm is frequently found recently and have recognized as precancerous lesions to pancreatic cancer that 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 tumors are asymptomatic and often multifocal. Preoperative differentiation between benign and malignant lesions is important to select the most appropriate treatment and to improve prognosis. Surgical resection is the treatment of choice to avoid malignant transformation when predictive factors for malignancy are present. These factors include mural nodule in the cyst, main pancreatic duct dilation, thick septum, cyst greater than 3 cm, atypias in the cyst fluid and the presence of symptoms. The follow-up of these patients who do not undergo surgical resection, is of great importance, since patients with IPMN appear to be at risk for pancreatic cancer. Patients who retain a portion of their pancreas following resection of an IPMN need to be followed up with periodic imaging to detect recurrences and metachronous lesions. (Korean J Med 2014;86:152-161)