BACKGROUND: With the use of modern cross-sectional abdominal imaging modalities, an increasing number of cystic @entity660 are identified incidentally. Although there is no pathological diagnosis available in most cases, it is believed that the majority of these lesions display small branch-duct intraductal @entity4929 (BD-IPMNs) of the pancreas. Even though a number of large clinical series have been published, many uncertainties remain with regard to this entity of mucinous @entity5 . METHODS: Systematic literature review. RESULTS: @entity1157 ( @entity1157 ) and mixed-type IPMNs harbor a high risk of malignant transformation. It is conceivable that most IPMNs with involvement of the main duct tend to progress to @entity189 over time. Thus, formal oncologic resection is the treatment of choice in surgically fit @entity1 . In contrast, the data regarding BD-IPMN remain equivocal, resulting in conflicting concepts. To date, it is not clear whether and which BD-IPMNs progress to @entity189 and how long this progression takes. CONCLUSION: While @entity1 with @entity1157 -IPMNs should undergo surgical resection if comorbidities and life expectancy permit this, the management of small BD-IPMNs remains controversial. Population-based studies with long-term follow-up are needed to define which cohort of @entity1 can be observed safely without immediate resection.

Natural History and Management of Intraductal XXXX : Current Evidence.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity4929 :: ('MESH:C565310', 'Disease') :: ['papillary mucinous neoplasms'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cystic neoplasms'] @entity1157 :: ('MESH:D001649', 'Disease') :: ['MD', 'Main-duct'] @entity660 :: ('MESH:D010182', 'Disease') :: ['pancreatic lesions'] @entity189 :: ('MESH:D002277', 'Disease') :: ['carcinoma', 'invasive carcinoma']
@entity4929 :: (MESH:C565310,Disease) :: ['Papillary Mucinous Neoplasms']
