Master of Science in Nursing (MSN) Student Scholarship

Date Written

Fall 2014

Document Type

Project

Course Number

NURS 5330

Course Name

Advanced Pathophysiology

Professor’s Name

John D. Chovan, James R. Cacchillo

Keywords

Pancreatic Adenocarcinoma, Patient Outcomes

Subject Categories

Medical Pathology | Neoplasms | Nursing

Abstract

Intraductal papillary mucinous neoplasms (IPMN) are uncommon tumors arising from the main pancreatic duct, branching pancreatic ducts, or both. The “overall incidence of invasive carcinoma associated with resected IPMN has been reported to be 20-40%” (Mohri et al., 2011). Due to their malignant potential, these lesions, along with mucinous cystic neoplasms (MCN), are considered more worrisome, and often require surgical resection (Gallucci, Langellotto, De Ritis, & Uomo, 2012). Even after removal of a primary lesion, patients remain under surveillance to monitor for recurrence, the rate of which is approximately 6 % (Gallucci et al., 2012), and patients with main duct IPMN are at a higher risk for developing pancreatic , gastric and colon adenocarcinoma over their lifetimes (Sheth, Howell & Kent, 2014). While both main duct and side branch lesions are considered pre-malignant, management of IPMN has not been well-established (Mohri et al., 2011) and ranges from watchful waiting to surgical resection, depending upon the suspicion of malignancy, the operation required and the relative risk to the patient. A lower threshold for surgical resection is present for main duct IPMNs, as they have a higher risk of associated malignancy (Sahora & Castillo, 2014). The incidence of pancreatic adenocarcinoma arising from IPMN has been well documented (Mohri et al., 2011). This poster discusses one such case. The patient’s IPMN was initially discovered incidentally, during evaluation of an unrelated medical diagnosis. As practitioners, it is important to be able to recognize IPMN as pre-malignant lesions and to act quickly to identify patients requiring further work-up. Since the prognosis of pancreatic adenocarcinoma is dismal, the early identification and treatment of IPMN, or pre-malignant lesions is imperative to improve outcomes (Mohri et al., 2011).

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