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Intraductal papillary mucinous neoplasm: Overview of management
June Oo1, Lisa Brown2, Benjamin PT Loveday3
1MBBS, FRACS, General and Hepatopancreatobiliary Surgeon, Department of Surgery, Alfred Hospital, Melbourne, Vic; Hepatopancreatobiliary Surgeon, Department of Surgery, Royal Melbourne Hospital, Melbourne, Vic; General Surgeon, Department of Surgery, Grampians Health, Ballarat, Vic.
Background:
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is increasingly being diagnosed incidentally on imaging. It has malignant potential, making it vital to establish the correct diagnosis, assess its malignant risk and follow a management strategy to prevent development of invasive carcinoma of the pancreas.
Objective:
This review focuses on the epidemiology, natural history, risk factors, diagnosis and management of IPMN of the pancreas, and will provide practical points for general practitioners.
Discussion:
IPMN of the pancreas can transform into invasive pancreatic carcinoma at a low rate of approximately 2%/year. Upon diagnosis of IPMN, it is risk stratified based on the presence of worrisome or high-risk stigmata, which guides further management. Management needs to be individualised based on IPMN and patient factors due to limitations with the current diagnostic tools.
