Patients Fifty-three consecutive patients who underwent pancreatic resection for intraductal papillary-mucinous tumors between January 1, 1985, and December 31, 2000.
Results Macroscopic analyses of tumors showed 6 main duct lesions, 12 branch duct lesions, and 35 combined lesions. A carcinoma was present in 33 cases (62%): 22 (41%) were invasive and 11 (21%) were noninvasive; 9 (17%) were borderline tumors and 11 (21%) were benign. Carcinoma and invasive carcinoma forms were less frequent in branch duct lesions (P<.001 and P = .009, respectively). Mural nodules were more frequent in carcinomas (P = .006) and invasive carcinomas (P<.001), with a positive predictive value of malignancy of 81%. The diameter of lesions (branch duct lesion =" src="http://archsurg.ama-assn.org/math/ge.gif" border=0>30 mm) or main duct (main pancreatic duct =" src="http://archsurg.ama-assn.org/math/ge.gif" border=0>15 mm in combined or main pancreatic duct lesions) did not correlate with malignancy.
Conclusions No carcinoma occurred in branch duct types smaller than 30 mm without mural nodules. Limited resection may be appropriate only in this type of tumor.
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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