Year 2024 / Volume 116 / Number 12
Letter
Pancreatic intraductal papillary mucinous neoplasm evolving into adenocarcinoma. Continual follow-up is necessary

713-714

DOI: 10.17235/reed.2023.9671/2023

Samer Mouhtar El Hálabi, Maria Desirée García García, Jesús Machuca Aguado, Camilo Andrés Romero González, Sebastian Umbría Jiménez, Federico Argüelles-Arias,

Abstract
We report a 62-year-old female with chronic pancreatitis after three episodes of severe acute pancreatitis. In 2008, an uneven main pancreatic duct (MPD) of 16 mm was found during an abdominal ultrasound. The follow-up was not continued until 2020, when a dilation of 27 mm of the MPD was discovered at magnetic resonance imaging (MRI). In 2022, another radiological test was carried out showing a dilation of the MPD of 40 mm with an intraductal tumoral lesion of 30 mm at the head of the pancreas). An echo-endoscopy was carried out and a pancreatic-duodenal tumour with a mixed pattern was discovered. Atypic cells were observed at the fine needle punction. A total duodenopancreatectomy was successfully carried out. In the anatomopathological macroscopic study a 14 cm-multi-cystic neoformation was seen and a solid tumour was discovered at the head of the pancreas that infiltrated the wall of the duodenum. In the longitudinal cross-section of the pancreatic body the MPD was seen to be severely dilated. A focal adenocarcinoma in a intraductal papillary mucinous neoplasm (IPMN) was finally diagnosed.
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References
1. Grace H. Elta, et al. ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts. Am J Gastroenterol 2018; 113:464–479
2. The European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut; 2018;67:789–804.
3. Ross C.D. Buerlein, et al. Management of pancreatic cysts and guidelines: what the gastroenterologist needs to know. Ther Adv Gastrointest Endosc, 2021, Vol. 14: 1–21
4. Annabelle L. Fonseca, et al. Intraductal Papillary Mucinous Neoplasms of the Pancreas: Current Understanding and Future Directions for Stratification of Malignancy Risk. Pancreas. 2018; 47(3): 272–279
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Mouhtar El Hálabi S, García García M, Machuca Aguado J, Romero González C, Umbría Jiménez S, Argüelles-Arias F, et all. Pancreatic intraductal papillary mucinous neoplasm evolving into adenocarcinoma. Continual follow-up is necessary. 9671/2023


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Publication history

Received: 16/04/2023

Accepted: 01/07/2023

Online First: 04/08/2023

Published: 13/12/2024

Article Online First time: 110 days

Article editing time: 607 days


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