Intraductal papillary-mucinous tumors of the pancreas: Presentation of eight cases

Background and study aims: The mucin-secreting intraductal papillary-mucino us tumors of the pancreas are a rare entity with characteristic duodenoscop ic and radiological features. These tumors have a broad spectrum of present ation. The diagnosis requires highly experienced and attentive endoscopists . Once diagnosed, resection of the tumor is recommended to prevent progress ion to malignancy. This surgical procedure has a low acceptance, mainly in the elderly patients. Therefore, a "wait and see" strategy may be necessary in those patients refusing operation. Patients and methods: Between 1996 and 2000, intraductal papillary-mucinous tumors of the pancreas were diagnosed in eight patients (5 females, 3 male s) using endoscopic retrograde cholangiopancreatography, and confirmed by b rush cytology and/or histology and analyzed retrospectively. Results: The patients showed typical endoscopic and radiological findings: dilatation and mucin extrusion of the papillary orifice, easy passage of in struments into the dilated main pancreatic duct, which showed patchy fillin g defects after application of contrast medium. Patients were informed abou t the diagnosis in detail. Two patients were inoperable. Surgery was recomm ended to the other six patients. Two of the six patients agreed to surgical treatment. The remaining four patients were included in a follow-up protoc ol. These patients were observed for up to 5 years. Only one patient showed minor progression of ERCP-findings. Conclusion: Intraductal papillary-mucinous tumors of the pancreas can be we ll characterized by means of endoscopy and radiology. Poor compliance to su rgical treatment makes individual multidisciplinary management and follow-u p necessary.