OBJECTIVES: This study aimed to analyze a large single-center population of resected @entity4929 ( @entity2403 ) of the pancreas with respect to risk factors of malignant transformation. BACKGROUND: There is international consensus that @entity1157 ( @entity1157 ) as well as mixed-type IPMNs should be treated surgically due to a high risk of @entity5 . In contrast, there is an ongoing controversy about surgery of branch-duct type @entity2403 ( @entity2403 ). METHODS: All consecutive @entity1 who underwent surgery for @entity2403 between January 2004 and December 2012 were included. Clinical characteristics and preoperative imaging were correlated with histopathological features. RESULTS: A total of 512 @entity1 underwent pancreatic surgery and had a histological proof of @entity2403 . According to preoperative imaging, 74 @entity1 had @entity1157 - @entity2403 (14%), 205 mixed-type (40%), and 233 suspected @entity2403 (46%). On histopathology, 162 of 512 @entity1 revealed low-grade, 105 moderate, and 52 high-grade @entity1141 . One hundred ninety-three @entity2403 @entity1 (38%) suffered from @entity189 . Among invasive IPMNs, the majority (58%) were mixed-type lesions according to preoperative imaging. Of 141 Sendai negative BD-IPMNs, a @entity5 rate of 18% (high-grade @entity1141 and @entity189 ) was found. Most interesting, 29% of suspected BD-IPMNs (67/233) revealed histological involvement of the main pancreatic duct not evident in preoperative imaging. CONCLUSIONS: All subtypes of IPMNs display a relevant risk for malignant transformation. By abdominal imaging, many IPMNs are misclassified as BD-IPMNs but reveal mixed-type lesions in histopathology. Because currently available preoperative diagnostics are not sufficient to reliably diagnose BD-IPMNs, surgical resection for suspected small branch-duct @entity2403 should be considered in @entity1 fit for surgery.

Pancreatic XXXX involvement in branch-duct IPMNs: an underestimated risk.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity4929 :: ('MESH:C565310', 'Disease') :: ['intraductal papillary mucinous neoplasms'] @entity5 :: ('MESH:D009369', 'Disease') :: ['malignancy'] @entity1157 :: ('MESH:D001649', 'Disease') :: ['main-duct', 'MD'] @entity189 :: ('MESH:D002277', 'Disease') :: ['invasive carcinoma'] @entity2403 :: ('MESH:D001528', 'Disease') :: ['BD-IPMN', 'IPMN'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia']
@entity1157 :: (MESH:D001649,Disease) :: ['main-duct']
