Muzinöse Neoplasien des Pankreas: Übersicht und eigene Erfahrungen

Zusammenfassung

Zwischen 2000 und 2007 wurden im Sana Klinikum Lichtenberg und im Unfallkrankenhaus Berlin 14 intraduktale papilläre muzinöse Neoplasien (IPMN) und 2 muzinös-zystische Neoplasien (MCN) des Pankreas operiert. Die IPMN-Patienten, 6 Frauen und 8 Männer, waren zwischen 47 und 84 Jahren alt. Fünf IPMN waren im Pankreaskopf, 6 im Korpus bzw. Korpus und Schwanz, 3 im Schwanz lokalisiert. Fünf IPMN waren Borderline-Läsionen, 3 Carcinomata in situ und 6 IPMN-assoziierte Karzinome. Unter den nicht invasiven IPMN fanden sich 5 intestinale, 1 gastraler, 1 pankreatobiliärer und 1 onkozytärer Typ. Beide MCN-Patienten waren weiblich und 69 Jahre bzw. 76 Jahre alt. Es fanden sich ein muzinöses Zystadenom im Pankreaskopf sowie eine muzinös-zystische Borderline-Läsion im Pankreasschwanz. IPMN zeigen eine ausgeglichene Geschlechterverteilung und sitzen meist im Pankreaskopf. MCN kommen nahezu ausschließlich bei Frauen vor, sitzen häufiger im Pankreasschwanz, zeigen ein ovarielles Stroma und kommunizieren anders als IPMN nicht mit dem Pankreasgangsystem. MCN gelten nach R0-Resektion als geheilt. IPMN werden als genetisch determinierte Systemerkrankung des Pankreas mit hoher Rezidivneigung und häufigerer Komalignität angesehen. Die Einteilung der IPMN nach Epitheltyp oder Gangverteilungsmuster (Hauptgangtyp, Tochtergangtyp) hat derzeit keine prognostische Relevanz. 

Abstract

Between 2000 and 2007, 14 intraductal papillary mucinous neoplasms (IPMN) and 2 mucinous cystic neoplasms (MCN) of the pancreas were surgically removed. IPMN patients were 47 to 84 years old, 6 were female and 8 male. Five IPMN were located in the head, 6 in body or body / tail, and 3 in the tail. Five IPMN were borderline lesions, 3 in situ carcinomas, and 6 IPMN-associated carcinomas. Five non-invasive IPMN showed an intestinal type epithelium, 1 a gastral type, 1 a pancreatobiliary type and 1 an oncocytic type. Both MCN patients were females and 69 and 76 years old. A mucinous cystadenoma was located in the pancreatic head, a mucinous-cystic borderline lesion was found in the tail. IPMN show an equal gender distribution and are located predominantly in the pancreatic head while MCN occur almost exclusively in females, are predominantly localised in the tail, are associated with an ovarian stroma and, unlike IPMN, do not communicate with the duct system. Complete resection is curative in MCN. IPMN are genetically determined systemic lesions of the pancreas with high rates of recurrence and malignancy. Classification of IPMN according to epithelial type or location in the pancreatic duct (main duct type, branch duct type) are currently not believed to be prognostically relevant. 

Schlüsselwörter

muzinöse Tumoren - muzinös-zystische Neoplasie - intraduktale papilläre muzinöse Neoplasie - Pankreas - Klassifikation

Key words

mucinous tumours - mucinous-cystic neoplasia - intraductal papillary mucinous neoplasia - pancreas - classification

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