SMALL INTRADUCTAL PAPILLARY-MUCINOUS ADENOMAS OF THE PANCREAS

Intraductal papillary-mucinous tumors in the pancreas have recently be en described as a distinct entity, but the classification of these neo plasms remains under debate. Of issue is the biologic potential of the se lesions and the predictability of clinical behavior on the basis of histologic appearance. We report two cases with intraductal papillary tumors formed by highly differentiated mucin-containing columnar epit helium found incidentally at autopsy. Both were classified as adenomas on the basis of histologic features. Neither patient experienced symp toms from their lesion during life and both died of other causes. Both lesions were studied by the polymerase chain reaction and were found to harbor codon 12 mutations in the c-K-ras gene. The concept that the se neoplasms represent an early stage in an adenoma-carcinoma sequence is discussed.