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Intraductal Papillary Mucinous Neoplasms of Pancreas: The Good, the Bad, and the Ugly.

Mondal U, Echavarria J, Lee G, Patel S, Rosenkranz L - ACG Case Rep J (2015)

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Nutrition, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.

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Intraductal papillary mucinous neoplasms (IPMN) arise from main pancreatic duct (MD-IPMN) and/or branch ducts (BDIPMN), and are characterized by intraductal papillary proliferation of mucin-producing epithelial cells exhibiting various degrees of dysplasia... The Good: A 62-year-old woman presented with bloating, unintended weight loss, loose stools, and a past history of heavy alcohol and tobacco use... The Bad: A 77-year-old man with history of heavy alcohol and tobacco use presented with unintended weight loss and recurrent episodes of abdominal pain... EUS showed segmental dilation of the pancreatic duct (PD) up to 20 mm in the body of pancreas, no mural nodules, and no chronic pancreatitis... Pancreatos-copy showed mucous plug obstructing a gaping papilla (Figure 3) and an MD-IPMN with mural nodules (papillary projections) giving a “fish egg” appearance (Figure 3)... The patient was evaluated for surgical resection, but he decided to undergo close surveillance... The Ugly: A 73-year-old man presented with profound weight loss and severe abdominal pain... Lee obtained the images... Patel and L... Rosenkranz revised the manuscript... Financial disclosure: None to report... Informed consent was obtained for this case report.

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Related in: MedlinePlus

(A) Fistula formation between main pancreatic duct, stomach, and duodenum. (B) Intracystic polypoid lesions seen on pancreatoscopy.
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Figure 4: (A) Fistula formation between main pancreatic duct, stomach, and duodenum. (B) Intracystic polypoid lesions seen on pancreatoscopy.

Mentions: The Ugly: A 73-year-old man presented with profound weight loss and severe abdominal pain. EUS showed PD dilation up to 20 mm with a cystic lesion in the head of pancreas extending into the gastric and duodenal wall. Upper endoscopy revealed a fistula adjacent to the ampulla covered in profuse amount of thick mucous (Figure 4). Intracystic pancreatoscopy revealed multiple polypoid lesions (Figure 4), and biopsy confirmed moderately differentiated adenocarcinoma of IPMN origin. He was not a surgical candidate and later passed away.


Intraductal Papillary Mucinous Neoplasms of Pancreas: The Good, the Bad, and the Ugly.

Mondal U, Echavarria J, Lee G, Patel S, Rosenkranz L - ACG Case Rep J (2015)

(A) Fistula formation between main pancreatic duct, stomach, and duodenum. (B) Intracystic polypoid lesions seen on pancreatoscopy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508940&req=5

Figure 4: (A) Fistula formation between main pancreatic duct, stomach, and duodenum. (B) Intracystic polypoid lesions seen on pancreatoscopy.
Mentions: The Ugly: A 73-year-old man presented with profound weight loss and severe abdominal pain. EUS showed PD dilation up to 20 mm with a cystic lesion in the head of pancreas extending into the gastric and duodenal wall. Upper endoscopy revealed a fistula adjacent to the ampulla covered in profuse amount of thick mucous (Figure 4). Intracystic pancreatoscopy revealed multiple polypoid lesions (Figure 4), and biopsy confirmed moderately differentiated adenocarcinoma of IPMN origin. He was not a surgical candidate and later passed away.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Nutrition, Department of Medicine, University of Texas Health Science Center, San Antonio, TX.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Intraductal papillary mucinous neoplasms (IPMN) arise from main pancreatic duct (MD-IPMN) and/or branch ducts (BDIPMN), and are characterized by intraductal papillary proliferation of mucin-producing epithelial cells exhibiting various degrees of dysplasia... The Good: A 62-year-old woman presented with bloating, unintended weight loss, loose stools, and a past history of heavy alcohol and tobacco use... The Bad: A 77-year-old man with history of heavy alcohol and tobacco use presented with unintended weight loss and recurrent episodes of abdominal pain... EUS showed segmental dilation of the pancreatic duct (PD) up to 20 mm in the body of pancreas, no mural nodules, and no chronic pancreatitis... Pancreatos-copy showed mucous plug obstructing a gaping papilla (Figure 3) and an MD-IPMN with mural nodules (papillary projections) giving a “fish egg” appearance (Figure 3)... The patient was evaluated for surgical resection, but he decided to undergo close surveillance... The Ugly: A 73-year-old man presented with profound weight loss and severe abdominal pain... Lee obtained the images... Patel and L... Rosenkranz revised the manuscript... Financial disclosure: None to report... Informed consent was obtained for this case report.

No MeSH data available.


Related in: MedlinePlus