The IPMTs were classified as invasive carcinoma in 22 cases (41%), noninvasive carcinoma (carcinoma in situ or severe dysplasia) in 11 cases (21%), borderline (moderate dysplasia) in 9 cases (17%), and adenoma (mild dysplasia) in 11 cases (21%). A malignant form was found in 73% of cases (24/33) in patients aged 60 years or older and in 45% (9/20) of the remaining patients (P = .04).
There were 6 cases of main duct type (11%), 12 cases of branch duct type (23%), and 35 cases of combined duct type (66%). The numbers of malignant or invasive forms were similar according to right or left location of the tumor. In fact, a malignant form was noted in 61% (22/36) of cases with a right location and in 55% (6/11) in cases with a left location. Furthermore, an invasive form was found in 44% (16/36) with right location and in 27% (3/11) with left location (middle and total pancreatectomies were excluded).
The correlations between the histologic grade and the classification used by Sugiyama and Atomi2 are shown in Table 1. The rate of malignant tumors was significantly higher in the main duct type (83%; P = .02) and in the combined type (74%; P = .002) compared with the branch duct type (17%). Among the malignant forms, the rate of invasive carcinomas was significantly higher in the main duct type (83%; P = .004) and in the combined duct type (46%; P = .04) compared with the branch duct type (8%). The rate of carcinoma ranged from 17% to 76% according to the absence or presence of main pancreatic duct lesions (P<.001), and the rate of invasive carcinoma ranged from 8% to 51% according to the absence or presence of main pancreatic duct lesions (P = .009). A benign form (adenoma and borderline) was more frequent in the branch duct type (83%) than in the main duct type (17%; P = .02) or the combined type (26%; P = .002).
Arch Surg -- Intraductal Papillary-Mucinous Tumors of the Pancreas: Predictive Criteria of Malignancy According to Pathological Examination of 53 Cases, November 2002, Bernard et al. 137 (11): 1274
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