췌장의 관내 유두상 점액종의 임상적, 병리학적 고찰
Clinical & Pathological Characteristics of Intraductal Papillary Mucinous Tumor of the Pancreas
윤지섭, 김경식, 최진섭, 이우정, 김병로, 박영년, 지훈상, 윤동섭, 정준표, 조신일, 이효상,
소속 상세정보
윤지섭 ( Yun Ji-Sup )
연세대학교 의과대학 외과학교실
김경식 ( Kim Kyung-Sik )
연세대학교 의과대학 외과학교실
최진섭 ( Choi Jin-Sub )
연세대학교 의과대학 외과학교실
이우정 ( Lee Woo-Jung )
연세대학교 의과대학 외과학교실
김병로 ( Kim Byong-Ro )
연세대학교 의과대학 외과학교실
박영년 ( Park Young-Nyun )
연세대학교 의과대학 병리학교실
지훈상 ( Chi Hoon-Sang )
연세대학교 의과대학 외과학교실
윤동섭 ( Yoon Dong-Sup )
연세대학교 의과대학 외과학교실
정준표 ( Chung Jun-Pyo )
연세대학교 의과대학 내과학교실
조신일 ( Jo Shin-Il )
연세대학교 의과대학 외과학교실
이효상 ( Lee Hyo-Sang )
연세대학교 의과대학 외과학교실
KMID : 0371320030640020165
Abstract
Purpose: Intraductal papillary mucinous tumors of the pancreas (IPMT) are becoming increasingly recognized. Despite a better understanding of these conditions, IPMT still present difficulty relating to the predictive factors and the risk of relapse after surgery. The aim of this study was to investigate the clinical, and pathological characteristics of IPMT.
Methods: Between October 1998 and July 2002, 22 patients with IPMT underwent surgery. We retrospectively examined the clinicopathological features and surgical outcomes of these patients.
Results: The types of IPMT were as follows: dysplasia (1); adenoma (4); borderline malignancy (9); carcinoma in situ (3); and carcinoma, both non-invasive (3) and invasive (2). Lymph node metastasis was not found, but stromal invasion was found in the 2 cases of invasive carcinoma. The locations of the IPMT were as follows: head (6); uncinate process (11); body (4); and tail (1). There were 11 main duct types, 10 branched duct types and 1 combined. All patients underwent surgical resection, including 3 pancreaticoduodenectomies, 12 pylorus-preserving pancreaticoduodenectomies, 4 distal pancreatectomies with splenectomies, 2 near-total pancreatectomies with splenectomies, and 1 enucleation. There were no operative or hospital deaths. A recurrence of the IPMT following surgery occurred in 2 cases. Their pathological features were a carcinoma in situ and a borderline malignancy, but not the invasive type. However, one case of recurrence expired 7 month after surgery. A combination of other malignancies in these patients was found in 2 cases.
Conclusion: IPMT has a favorable prognosis, when compared with pancreatic duct carcinoma. However, long-term follow-up after surgery is necessary, even for a curative resection due to a recurrence or a combination of other malignancies. Because combination of other malignancies exist infrequently, surgeons should be aware of the possibility of co-existing other malignancies.
키워드
관내 유두상 점액종;췌장;특징
IPMT;Pancreas;Characteristics
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