What is intraductal papillary mucinous neoplasm (IPMN)?
An Intraductal Papillary Mucinous Neoplasm (IPMN) refers to a benign pancreatic cyst occurring within the ducts of the pancreas leading to the formation of mucin-producing papillary projections. It's considered a cystic tumor, with the potential to progress to cancer over time. IPMNs can vary in size, location, and degree of dysplasia (abnormal cell growth).
IPMNs contain cysts filled with mucin, a jelly-like substance. As benign cystic tumors progress to cancerous stages, they may produce more mucin, potentially leading to blockages in the pancreatic ducts. These blockages can result in pancreatitis, a painful condition affecting digestion.
What causes IPMN?
IPMNs are believed to occur due to genetic mutations affecting cell growth regulation or tumor suppression. Individuals with a family history of pancreatic ductal adenocarcinoma (PDAC) may be at higher risk of developing IPMNs.
What are the symptoms of IPMN?
IPMNs often manifest without specific symptoms and may be incidentally discovered during tests for other conditions. Common symptoms of IPMNs include:
- Intermittent abdominal pain
- Unintended weight loss
- Nausea or vomiting
- Back pain
- Oily stool
Additionally, IPMNs can mimic symptoms of other conditions like jaundice, new-onset diabetes, or pancreatitis.
How is IPMN diagnosed?
Diagnosing IPMN typically involves a combination of medical history review, physical examination, laboratory tests, and imaging studies such as abdominal ultrasound, CT scan, MRI, or endoscopic ultrasound (EUS) to visualize the lesion and assess its characteristics.
What are treatment options for IPMN?
Treatment for IPMN depends on various factors, including the size, location, degree of dysplasia, and presence of symptoms. Treatment options may include:
- Small, asymptomatic IPMNs with low-risk features may be monitored regularly with follow-up imaging studies to assess for any changes in size or appearance.
- Surgical removal of the lesion (partial pancreatectomy) may be recommended for IPMNs that are large, growing, symptomatic, or associated with high-risk features (e.g., high-grade dysplasia or worrisome radiographic features).
- Endoscopic procedures such as endoscopic retrograde cholangiopancreatography (ERCP) with papillectomy or stent placement may be used to alleviate symptoms or reduce the risk of complications in select cases.