概述

An intraductal papillary mucinous neoplasm (IPMN) is a tumor that forms in the pancreas. The pancreas is a large organ behind the stomach. It produces hormones to control blood sugar and enzymes that help digest food. IPMNs grow in the tubes, called ducts, that carry enzymes out of the pancreas and into the digestive system.

IPMNs are not cancer, but some higher risk lesions may become cancerous or have a small cancer growing in them. Some IPMNs may never cause health concerns. Your healthcare team can monitor an IPMN over time for changes that raise the risk of cancer or are precancerous.

IPMNs can be present in the pancreas long before being diagnosed. Many IPMNs are incidentally seen on imaging tests done for other reasons. Small, very low-risk IPMNs that do not cause symptoms often don't need any further care. Other low-risk IPMNs are often monitored with imaging.

If an IPMN has features linked to a higher risk of cancer, your care team may suggest more-frequent testing. This helps them watch for changes and decide whether treatment is needed. If an IPMN needs to be removed, surgery is the standard treatment.

There is no proven medicine, diet, supplement or other regimen that gets rid of an IPMN or prevents a high-risk IPMN from becoming cancer. Following your recommended surveillance plan helps your care team monitor the IPMN and suggest medical options for you. Ask your care team about any treatments or products you're considering.

Types

Intraductal papillary mucinous neoplasms (IPMNs) grow in saclike pockets of fluid called cysts. There are several types of cysts that can be found in the pancreas. Some never cause health concerns and some have a high risk of causing medical conditions.

IPMNs are called mucinous because they make a thick fluid called mucin. That thick fluid sometimes blocks the ducts in the pancreas, causing symptoms such as pain.

There are three main types of intraductal papillary mucinous neoplasm.

  • Main-duct IPMN. This is a growth in the main pancreatic duct. These IPMNs may be watched closely for changes that could lead to cancer.
  • Branch-duct IPMNs. These growths also may be called BD-IPMN or side-branch IPMN. They develop in the smaller ducts that come off the main duct in the pancreas. When there are multiple IPMNs in the smaller ducts, this is called multifocal IPMN. These tend to have lower risk of cancer.
  • Mixed-type IPMN. This type of IPMN affects both the main pancreatic duct and branching ducts.

Main-duct and mixed-type IPMNs usually need closer monitoring because they may have a higher risk of cell changes that could lead to cancer. Branch-duct IPMNs are more common in younger people. Compared with main-duct IPMNs, branch-duct IPMNs have a lower risk of serious cell changes.

症状

Intraductal papillary mucinous neoplasms (IPMNs) often cause no symptoms. Your healthcare team may see the growths on some imaging scans of the abdomen.

When symptoms happen, they may include:

  • Not feeling hungry.
  • Feeling sick to your stomach.
  • Throwing up.
  • Yellowing of the skin and eyes, called jaundice.
  • Pain in the stomach or back.

IPMN-related pain may happen when the mucin made by the tumor blocks the duct in the pancreas. This can lead to swelling and irritation of the pancreas, called pancreatitis, and problems with digestion.

病因

It is not clear what causes intraductal papillary mucinous neoplasms (IPMNs) to develop. Over time, the cells in the pancreas can develop changes in their DNA. These changes contribute to unusual cell growth and development of IPMNs.

The pancreas releases hormones, including insulin. These hormones help the body process the sugar in the foods you eat. The pancreas also makes digestive juices to help the body digest food and take in nutrients.

风险因素

Intraductal papillary mucinous neoplasms (IPMNs) are more common as you age.

In addition to age, some research has linked IPMN development to:

  • Cigarette smoking.
  • Diabetes.
  • Chronic pancreatitis.
  • Family history.

A family history of pancreatic cancer may raise the risk of getting an IPMN or pancreatic cancer. But it does not seem to raise the risk that a specific IPMN will progress to cancer.

并发症

Intraductal papillary mucinous neoplasms (IPMNs) can cause pancreatitis. This happens if the fluid made by the tumor, called mucin, or the tissue itself blocks the main pancreatic duct. If this happens often, treatment may be needed.

A complication of some IPMNs is that they may develop serious cell changes or become pancreatic cancer over time. Regular follow-up helps your care team look for these changes and is based on the type of IPMN you have.