Neoplasms of the pancreas

Cysts / IPMN (Intraductal Papillary Mucinous Neoplasia)

Cysts are mucus-containing areas in the body. An IPMN is an initially benign cystic neoplasm that localizes within the "ductal" cells of the pancreas (so-called cells of the excretory ducts). Frequently, these are incidental findings during ultrasound or CT examinations of the abdomen, as IPMN often do not cause any symptoms. A confirmed diagnosis is often most specific by MRI.

Intraductal papillary mucinous neoplasms may be precursors to a malignant pancreatic tumor. The affected excretory ducts are divided into main duct and lateral ducts. The location in relation to the duct system (main duct, side duct, mixed), the number and the size of the cystic dilations are relevant for the risk of degeneration to a malignant tumor. Prognostic factors favoring cancer development are an involvement of the main duct, an increased number of cysts and a diameter of a cyst >3cm.

Patients with IPMN have an overall increased risk of other benign or malignant tumors in the body, e.g. colon polyps or esophageal cancer. The cause of this and the mechanisms for developing a malignant pancreatic tumor as a result of an IPMN are still scientifically unclear.

Cystic neoplasms are often localized in the pancreatic head, but other sections of the gland may also be affected. If the risk of cancer development is high, preventive surgery with removal of the affected section is recommended (e.g., Whipple surgery for involvement of the pancreatic head). If the risk of degeneration is low, regular annual check-ups may be sufficient. In the case of medium risk constellation, the surgical treatment should be considered individually in close dialogue with the patient, since it is a precautionary intervention.

(Author: Benedict Kinny-Köster, MD - Surgeon)

Symptoms

Often no symptoms
Possibly increasing upper abdominal pain
Possibly nausea and vomiting, weight loss, fever, night sweats
Rarely yellowing of the skin
Rarely triggers acute pancreatitis

Risk factors

Hardly any risk factors known
Frequent occurrence without presence of risk factors (origin unclear)
Chronic pancreatitis
Long-standing diabetes mellitus
Genetic predisposition

The European Pancreas Center, in cooperation with Abbott's KREON service, has compiled an information brochure for you.

Here you will find 86 pages of compact basic knowledge on the subject of "Diseases of the pancreas".
It is about:

Pancreatic tumors
Chronic pancreas inflammation
Acute pancreatitis

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Pancreatic neoplasms: IPMN and cysts