Natural history of pancreatic intraductal papillary mucinous tumor of branch duct type - Follow-up study by magnetic resonance cholangiopancreatography

Objective: The purpose of this study was to elucidate the natural history of branch duct type pancreatic intraductal papillary mucinous tumor (IPMT) by evaluating serial changes in the magnetic resonance cholangiopancreatography (MRCP) findings of patients diagnosed with pancreatic IPMT of branch duct type. Methods: Thirty-five patients had branch duct type IPMT, including 9 patients with separate lesions, and underwent initial and followup MRCP over a period of more than 12 months. The maximum diameter of the cystic lesion, the presence of associated main pancreatic duct (MPD) dilatation, and the presence of a filling defect were evaluated. Serial changes in these findings were analyzed. Results: Tumor enlargement on follow-up MRCP was observed in 7 cases. Of the 29 branch duct IPMTs without associated MPD dilatation or a filling defect identified on initial MRCP, only 1 showed gradual tumor enlargement. In 4 cases, the cyst size decreased on follow-up MRCP. Conclusions: Branch duct type IPMTs grow slowly and can be monitored without operation provided that the tumor shows no associated MPD dilatation or filling defect.