Branch-Duct Pancreatic Tumors Less Likely to Be Malignant

Study results support conservative treatment recommendations

FRIDAY, July 20 (HealthDay News) -- Intraductal papillary mucinous neoplasms (IPMNs) in the branch ducts of the pancreas are significantly less likely to be malignant than IPMNs arising in the main ducts, according to a report in the July issue of Gastroenterology.

Carlos Fernandez-del Castillo, M.D., of the Massachusetts General Hospital in Boston, and colleagues studied data from 145 patients from Massachusetts General Hospital and from the University of Verona in Italy who had branch-duct neoplasms surgically resected between 1990 and 2005.

The patients had a variety of diagnoses, ranging from adenomas to invasive carcinomas with distant metastases. Overall, the likelihood of invasive carcinoma was less than in main-duct tumors found in a previous study (11 percent versus 42 percent). Patients with cancer were more likely to have jaundice (12.5 percent versus 1.8 percent), tumors 30 mm or larger, nodules and symptoms. However, those with benign tumors were more likely to have abdominal pain (45 percent versus 25 percent).

"This large cohort of resected branch-duct IPMNs shows that cancer is present in 22 percent of cases and validates the recent guidelines that indicate absence of malignancy in tumors less than 30 mm, without symptoms or mural nodules," the authors conclude.

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