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Mucinous Tumours of the Pancreas

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Surgical Diseases of the Pancreas and Biliary Tree

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Abstract

Cystic neoplasms of the pancreas are increasingly identified due to the progressively common usage of cross-sectional imaging for investigation of abdominal conditions. Mucinous cystic lesions account for more than a quarter of these ‘cysts’. Although mucinous cystic neoplasms and intraductal papillary mucinous neoplasms are now recognised as two distinct entities, both are recognised as precursors to the development of pancreatic cancer. Research into molecular pathology has improved our knowledge of pathogenesis and outcomes of these lesions. Management options are evolving, but practices vary not only from centre to centre but also from healthcare system to healthcare system. To answer to this, consensus guidelines have been published based on current evidence, in order to standardise management of these lesions and improve outcomes. Future research to develop novel biomarkers and identify optimal imaging technique will help identify subpopulations at risk that will benefit from earlier intervention.

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Abbreviations

AJCC:

American Joint Committee on Cancer

BD-IPMN:

Branch-duct intraductal papillary mucinous neoplasm

CA 19-9:

Carbohydrate antigen

CEA:

Carcinoembryonic antigen

Cox2:

Cyclooxygenase 2

DNA:

Deoxyribonucleic acid

EUS:

Endoscopic ultrasound

FNA:

Fine needle aspiration

GNAS:

Guanine nucleotide-binding protein, alpha stimulating

hTERT:

Human telomerase reverse transcriptase

IAP:

International Association of Pancreatology

IPMN:

Intraductal papillary mucinous neoplasm

KRAS:

Kirsten rat sarcoma viral oncogene

LKB1:

Liver kinase B1

MCL:

Mucinous cystic lesions

MCN:

Mucinous cystic neoplasm

MD-IPMN:

Main-duct intraductal papillary mucinous neoplasm

MDCT:

Multi-detector computed tomography

MDT:

Multidisciplinary team meeting

MPD:

Main pancreatic duct

MRCP:

Magnetic resonance cholangiopancreatography

MRI:

Magnetic resonance imaging

MUC1:

Mucin 1

MUC2:

Mucin 2

MUC5AC:

Oligomeric mucus/gel-forming

O.R.:

Odds ratio

p53:

Tumour protein p53

Pan IN:

Pancreatic intraepithelial neoplasia

PDAC:

Pancreatic ductal adenocarcinoma

PET-CT:

Positron emission tomography-computed tomography

PJS:

Peutz–Jeghers syndrome

PPV:

Positive predictive value

SCA:

Serous cystadenoma

Shah:

Sonic hedgehog

STK11:

Serine/threonine kinase 11

TNM:

Union for International Cancer Control

USA:

United States of America

WHO:

World Health Organization

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Authors and Affiliations

  1. Department of Clinical Cancer Medicine, University of Liverpool, Liverpool, UK

    Rohith G. Rao MB BS FRCS & Christopher M. Halloran BSc MB ChB MD FRCS

  2. Department of Radiology, Royal Liverpool University Hospital, Liverpool, UK

    Priya Healey MB BS DMRD FRCR

  3. Department of Pancreatobiliary Surgery, Royal Liverpool University Hospital, Liverpool, UK

    Christopher M. Halloran BSc MB ChB MD FRCS

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  1. Rohith G. Rao MB BS FRCS
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  2. Priya Healey MB BS DMRD FRCR
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  3. Christopher M. Halloran BSc MB ChB MD FRCS
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Correspondence to Christopher M. Halloran BSc MB ChB MD FRCS .

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Editors and Affiliations

  1. Gastrointestinal Surgery, Medanta – The Medicity, Gurgaon, Haryana, India

    Savio George Barreto

  2. Professor of Surgery, HBP/Upper GI Surgeon, Auckland City Hospital, University of Auckland, Auckland, New Zealand

    John A. Windsor

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Rao, R.G., Healey, P., Halloran, C.M. (2018). Mucinous Tumours of the Pancreas. In: Barreto, S., Windsor, J. (eds) Surgical Diseases of the Pancreas and Biliary Tree. Springer, Singapore. https://doi.org/10.1007/978-981-10-8755-4_12

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