The Diagnosis And Treatment Of Intraductal Papillary Mucinous Neoplasms(IPMN):a Case Report

Background and aimIntraductal papillary mucinous neoplasms(IPMN) is a rare cystic disease of pancreas for the characteristics of the dilation of main pancreatic duct, the opening of ampullaand mucinous secretion of pancreatic duct. It can be divided intothree types include in morphology:main duct IPMN, branch duct IPMN and mixed type respectively. IPMN is supposed to have malignant tendency, it is necessary to differentiate with pseudocyst, solid papilloma, cystadenoma, cystadenocarcinoma and pancreatic adenocarcinoma carefully. The incidence of IPMN is increased in recent years. Herein, we report a case of IPMN which finally diagnosed with adenocarcinoma. A49-year-old man complained abdominal pain after the meal for10months, radiographyincluded ultrasonography,CT and MRI all showed an occupation at the head of pancreasmain duct dilation. EUS was used for further investigation, IPMN is considered with malignancy. As a consequence, pancreaticoduodenectomy (Whipple procedure) was performed. The intraoperative frozen sectiondiagnosis revealed pancreatic adenocarcinoma which is related with IPMN. After the supporting therapy, the patient recovered and discharged. Because of its malignant potential, IPMN is indispensable differential diagnosis of pancreatic tumors.Contrast-enhanced CT, MRI, MRCP and EUS play a significant part in diagnosis and differential diagnosis of IPMN. So far, surgical resection is remain the most effective therapy. The follow up of the recurrence and change of the tumor markers could be the further studied.Methods:We report a case of pancreatic cystic tumor. After admission,the patient complete the laboratory tests and images and put forward primary diagnosis. The proper surgical procedure was chosen according to the characteristics of the tumor and the patient himself. Then we review the relevant English literatures, the features of IPMN were summarized to provide valuable reference for diagnosis and treatment.Conclusion:Diagnosis and differential diagnosis of pancreatic ductal papilloma requires a combination of patient history, clinical presentation, laboratory and imaging studies analyzed. Surgery remains the main treatment for malignant IPMN.