Pancreatic Cysts and Intraductal Papillary Mucinous Neoplasm in Autosomal Dominant Polycystic Kidney Disease
| Autor: | Patrick S. Kamath, William P. Martin, Vicente E. Torres, Marie C. Hogan, Peter C. Harris, Walter K. Kremers, Ayush Sharma, Bairbre A. McNicholas, Suresh T. Chari, Naoki Takahashi, Marie E. Edwards, Yoshida Kotaro |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Autosomal dominant polycystic kidney disease urologic and male genital diseases Gastroenterology Asymptomatic Article Lesion 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine Outcome Assessment Health Care Internal Medicine Carcinoma medicine Humans Retrospective Studies Hepatology medicine.diagnostic_test Intraductal papillary mucinous neoplasm business.industry Magnetic resonance imaging Middle Aged medicine.disease Polycystic Kidney Autosomal Dominant Adenocarcinoma Mucinous Magnetic Resonance Imaging Pancreatic Neoplasms Adenocarcinoma Papillary 030220 oncology & carcinogenesis Mutation Adenocarcinoma 030211 gastroenterology & hepatology Female medicine.symptom Pancreatic cysts Pancreatic Cyst business Carcinoma Pancreatic Ductal |
| Zdroj: | Pancreas |
| ISSN: | 1536-4828 |
| Popis: | Objectives Pancreatic lesions in autosomal dominant polycystic kidney disease (ADPKD) are primarily cysts. They are increasingly recognized, with isolated reports of intraductal papillary mucinous neoplasia (IPMN). Methods Retrospective study to determine prevalence, number, size, and location of pancreatic abnormalities using abdominal magnetic resonance imaging (MRI) of genotyped ADPKD patients (seen February 1998 to October 2013) and compared with age- and sex-matched non-ADPKD controls. We evaluated presentation, investigation, and management of all IPMNs among individuals with ADPKD (January 1997 to December 2016). Results Abdominal MRIs were examined for 271 genotyped ADPKD patients. A pancreatic cyst lesion (PCL) was detected in 52 patients (19%; 95% confidence interval, 15%-23%). Thirty-seven (71%) had a solitary PCL; 15 (28%) had multiple. Pancreatic cyst lesion prevalence did not differ by genotype. Intraductal papillary mucinous neoplasia was detected in 1% of ADPKD cases. Among 12 IPMN patients (7 branch duct; 5 main duct or mixed type) monitored for about 140 months, 2 with main duct IPMNs required Whipple resection, and 1 patient died of complications from small-bowel obstruction after declining surgical intervention. Conclusions With MRI, PCLs were detected in 19% and IPMNs in 1% of 271 ADPKD patients with proven mutations, without difference across genotypes. Pancreatic cyst lesions were asymptomatic and remained stable in size. |
| Databáze: | OpenAIRE |
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