Malignant intraductal papillary mucinous tumours of the pancreas. A three cases report

##plugins.themes.academic_pro.article.main##

Wael Rebai
Rachid Ksantini
Amin Makni
Faouzi Chebbi
Oussama Baraket
Fathia Ben Hariz
Sofiene Ayadi
Amine Daghfous
Fadhel Fterich
Haykel Bedioui
Mohamed Jouini
Montasser Kacem
Zoubeir Ben Safta

Abstract

Background : Intra ductal papillary mucinous tumors of pancreas are rare and are characterized by a risk of malignant transformation.
Aim: To clarify their clinical presentation and the performance of different imaging examinations to determine their benign or malignant and achieve their staging.
Cases: We report three cases of degenerate intra ductal papillary mucinous tumors of pancreas. The combination of CT, the pancreato- MRI and duodenoscopy has led to the diagnosis in all cases. A pancreaticoduodenectomy were performed in two cases.
Conclusion: The various imaging techniques allow better detection and analysis of the tumor including the evaluation criteria of degeneration. The treatment of these lesions is still surgery.

Keywords:

Intraductal papillary mucinous neoplasm, Pancreas, Adenocarcinoma, Treatment

##plugins.themes.academic_pro.article.details##

References

  1. Azar C, Van de Stadt J, Rickaert F et al. Intraductal papillary mucinous tumours of the pancreas. Clinical and therapeutic issues in 32 patients.Gut 1996; 39:457-64.
  2. Bournet B, Buscail L, Escourrou J. Tumeur intracanalaire papillaire mucineuse du pancréas EMC -Hepatologie 2006 : 7- 106-A-18.
  3. Bernard JP, Payan MJ. Tumeurs intra canalaires papillaires mucineuses pancréatiques. Gastroenterol Clin Biol 1997; 21 : 274.
  4. Paye F, Sauvanet A, Ponsot P, Belghiti J. Les tumeurs intracanalaires papillaires mucineuses du pancréas. Diagnostic, traitement et pronostic. Ann Chir 1999; 53:598-604.
  5. Vullierme MP, Giraud-Cohen M, Hammel P et al. Malignant Intraductal Papillary Mucinous Neoplasm of the Pancreas: In Situ versus Invasive Carcinoma surgical Resectability. Radiology 2007 ; 245:483-90.
  6. Bernard P, Scoazec JY, Joubert M et al. Intraductal Papillary- Mucinous Tumors of the Pancreas: Predictive criteria of malignancy according to pathological examination of 53 cases. Arch Surg 2002; 137:1274-8.
  7. Sugiyama M, Atomi Y. Intraductal papillary mucinous tumors of the pancreas. Imaging studies and treatment strategies. Ann Surg 1998; 228 :685- 91.
  8. Cuillerier E, Cellier C, Palazzo L, et al. Tumeurs intracanalaires papillaires mucineuses du pancréas existe-t-il des facteurs pré opératoires cliniques et biologiques prédictifs de dégénérescence? Résultats d'une série collective franco-belge. Ann Chir 1998; 52:215-22.
  9. Traverso LW, Peralta EA, Ryan JA Jr, Kozarek RA. Intraductal neoplasms of the pancreas. Am J Surg 1998; 175:426-32.
  10. Rivera JA, Fernandez-del Castillo C, Pins M et al. Pancreatic mucinous ductal ectasia and intraductal papillary neoplasms. A single malignant clinicopathologic entity. Ann Surg 1997; 225:637-44.
  11. Van de Stadt J, Closset J, Gelin M. Intraductal papillary mucinous tumors (IPMT). Ann Surg 1999 ;230:828-9.
  12. Azar C, Van de Stadt J, Rickaert F, et al. Intraductal papillary mucinous tumours of the pancreas. Clinical and therapeutic issues in 32 patients. Gut 1996;39:457-64.
  13. Falconi M, Salvia R, Bassi C, Zamboni G, Talamini G, Pederzoli P. Clinicopathological features and treatment of intraductal papillary mucinous tumour of the pancreas. Br J Surg 2001;88:376-81.
  14. Siech M, Tripp K, Schmidt-Rohlfing B, Mattfeldt T, Görich J, Beger HG. Intraductal papillary mucinous tumor of the pancreas. Am J Surg 1999 ;177:117-20.
  15. Maire F, Hammel P, Terris B, et al. Prognosis of malignant intraductal papillary mucinous tumours of the pancreas after surgical resection. Comparison with pancreatic ductal adenocarcinoma. Gut 2002 ; 51:717-22.