Intraductal Papillary Mucinous Neoplasm of Pancreas with High-Risk Stigmata or Worrisome Features: What do You Do? Physician’s View
10.15279/kpba.2023.28.1.7
- Author:
Hyung Ku CHON
1
;
Tae Hyeon KIM
Author Information
1. Division of Biliopancreas, Department of Internal Medicine, Wonkwang University Medical School and Hospital, Iksan, Korea
- Publication Type:Review Article
- From:Korean Journal of Pancreas and Biliary Tract
2023;28(1):7-14
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
There are still debated about surveillance interval, duration, diagnostic modality and treatment for intraductal papillary mucinous neoplasm (IPMN) of the pancreas. In recent guidelines, ‘high risk stigmata (HRS)’ and ‘worrisome feature (WF)’ are defined as predictive factors for malignancy in IPMN. IPMNs with HRS and main duct- IPMN are more likely to accompany malignancies, thus require surgery. However, in the case of only WF, since the risk of malignancy is different for each factor, the management decision can be variable according to the number of overlapping WFs. In addition, for segmental main pancreatic duct dilatation without enhancing mural nodules, careful surveillance might be considered rather than immediate surgery. In IPMN patients with elderly or severe comorbidities, treatment strategy should be determined based on surgical and malignant risk assessment. To date, the natural course of IPMN patients with HRS and WF is not well understood, thus further studies with a large number of patients are needed.
