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Invited Critique
January 1, 2006

High Incidence of Extrapancreatic Neoplasms in Patients With Intraductal Papillary Mucinous Neoplasms—Invited Critique

Arch Surg. 2006;141(1):56. doi:10.1001/archsurg.141.1.56

In recent years, there have been an increasing number of studies evaluating outcome in patients with IPMN. As noted by the authors, some of these studies have suggested an increased risk of extrapancreatic neoplasms in patients with IPMN. The potential bias in reporting these findings, however, is that patients previously diagnosed with other malignancies are subject to closer surveillance, including a higher number of physician visits and imaging tests, which may increase the likelihood that they are subsequently diagnosed as having IPMN. In addition, because we now understand the significant chance for recurrence of IPMN in the pancreas (up to 23% at 32 months’ median follow-up in a recent series by D’Angelica et al1 at Memorial Sloan-Kettering), postoperative patients with a new diagnosis of IPMN are closely followed up postoperatively with imaging tests, which may increase the likelihood of discovering other extrapancreatic malignancies. Because of this, it is difficult to sort out the meaning behind what might appear to be a high risk of extrapancreatic neoplasms in patients with IPMN.

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