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IPMNs or Intraductal Papillary Mucinous Neoplasms are intraductal lesions whose papillary epithelial proliferation and mucin production leads to cystic dilatation of the involved ducts. CT and MRCP are useful for their diagnosis and characterization, making it possible to distinguish between main duct (MD), branch duct (BD) and mixed subtypes, which have different biological behaviors. They are precursors of invasive carcinoma, through increasing grades of dysplasia.

The malignancy rate is > 50% in MD-IPMNs. Surgical resection is recommended for surgically fit patients with a positive cytology anr/or high-risk stigmata (main pancreatic duct > 10 mm, jaundice or mural nodules).

All patients should undergo surveillance after resection to detect the development of a new IPMN requiring surgery of concomitant PDAC.

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Dr. Ana Alagoa Joao MD, MSc - General Surgery at HPB UnitSurgeon at HPB Unit Champalimaud Foundation, Portugal General Surgery
Dr. Marta Fragoso General Surgeon na Hospital Professor Doutor Fernando Fonseca, EPE General Surgery
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