Dilatation of the main pancreatic duct as first manifestation of small pancreatic ductal adenocarcinomas detected in a hereditary pancreatic cancer surveillance program
Open accessAbstract
Background MRI surveillance in a cohort of CDKN2A-p16-Leiden mutation carriers with a 20% lifetime risk of PDAC led to increased resection rates and improved survival. Patients with screen-detected PDAC were evaluated for main pancreatic duct (MPD) abnormalities in this retrospective review. Methods Since 2000 annual MRI and optional EUS was performed in mutation carriers. Data of patients with screen-detected PDAC was collected on gender, age at diagnosis, site of tumor, size, outcome of surgery, pathology findings and survival. All MRIs were re-evaluated for MPD abnormalities. Results 23 PDAC were detected in 22 (10%) of 217 mutation carriers, 10 (45%) males and 12 (55%) females. The mean age at diagnosis was 59.8 years (range 39.2-74.3 years). Revision of the MRI/MRCP revealed a lesion and dilatation of the MPD in 8 of the 22 patients. In 5 of 7 patients with PDAC detected during follow-up, the previous MRI showed MPD dilatation without evidence of tumor. The mean size of PDAC was 12.3 mm (range 5-19 mm). All tumors were resectable. Conclusion MPD dilation is common in patients with screen-detected PDAC. Abnormalities on MRI during surveillance of high-risk individuals requires intense follow-up or prompt treatment, as early treatment results in a better prognosis.
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MPD abnormalities are not specific to PDAC and are often observed in benign pancreatic diseases.
“However, MPD abnormalities are not specific to PDAC and are often observed in benign pancreatic diseases.”
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- Authors
- Vasen, H. F. A., Boekestijn, B., Ibrahim, I. S., Inderson, A., Bonsing, B. A., de Vos tot Nederveen Cappel, W. H., Feshtali, S., & Wasser, M. N.
- Affiliations
- Leiden University Medical Center (NL)
- Corresponding author
- Boekestijn, Bas
- ORCID
- Venue
- HPB
- Publisher
- Elsevier BV
- Published
- 2019-10
- Volume
- 21
- Issue
- 10
- Pages
- 1371-1375
- ISSN
- 1365-182X (ISSN-L)
- OpenAlex
- W2948081259
- Cited by
- 12
- References
- 17
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 2
- FWCI
- 0.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- HPB (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
- Keywords
- pancreatic ductal adenocarcinoma, main pancreatic duct dilatation, hereditary pancreatic cancer, MRI surveillance, MRCP, early cancer detection, pancreatic cancer screening, tumor resectability
- MeSH terms
- Adult, Aged, Carcinoma, Dilatation, Pathologic, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Mass Screening, Middle Aged, Pancreatic Ducts, Pancreatic Neoplasms, Prognosis, Retrospective Studies, Carcinoma, Pancreatic Ductal, Early Detection of Cancer
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