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Title: Does cyst growth predict malignancy in branch duct intraductal papillary mucinous neoplasms? Results of a large multicenter experience
Authors: El Chafic, Abdul
El Hajj, Ihab I
DeWitt, John
Schmidt, Christian M
Siddiqui, Ali
Sherman, Stuart
Aggarwal, Ashish
Al-Haddad, Mohammad
Affiliations: Faculty of Medicine 
Keywords: Branch-duct IPMN (BD-IPMN)
Endoscopic ultrasound
Molecular analysis
Cyst growth rate
Issue Date: 2018
Publisher: Elsevier
Part of: Digestive and Liver Disease
Volume: 50
Issue: 9
Start page: 961
End page: 968
Cyst growth of BD-IPMNs on follow-up imaging remains a concerning sign.

To describe cyst size changes over time in BD-IPMNs, and determine whether cyst growth rate is associated with increased risk of malignancy.

This is a retrospective study performed at two high volume tertiary centers. Mean cyst size at baseline (MCSB) and mean growth rate percentage (MGRP) were calculated. Rapid cyst growth was defined as MGRP ≥30%/year. Patient and cyst related characteristics were studied.

160 patients were followed for a median of 27.4 (12–114.5) months. MCSB was 15.1 ± 8.0 mm. During follow-up, 73 (45.6%) showed any cyst size increase, of which 15 cysts (9.4%) exhibited MGRP ≥30%/year. Rapid cyst growth was not associated with patient or cyst characteristics. Cyst fluid molecular analysis from 101 cysts showed KRAS mutation in 26. Compared to KRAS-negative cysts, neither MCSB (16.0 mm vs. 17.7 mm; p = 0.3) nor MGRP (3.9%/year vs. 5.8%/year; p = 0.7) was significantly different. Eighteen patients underwent surgery; 15 (83%) had LGD, and 3 had advanced neoplasia. Two cysts with LGD and one cyst with advanced neoplasia had MGRP ≥30%/year.

Increase in BD-IPMNs size was not associated with the known high risk patient or cyst-related characteristics. Rapid growth of BD-IPMNs was not associated with advanced neoplasia on surgical pathology.
ISSN: 15908658
DOI: 10.1016/j.dld.2018.04.022
Ezproxy URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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