Sammenhengen mellom kronisk pancreatitt, mucinøse lesjoner i pancreas og andre synkrone/metakrone cancere. ; The relationship between chronic pancreatitis, mucinous lesions of the pancreas and other synchronous/metachronous cancers.

Background: Pancreatic adenocarcinoma is a dreaded disease, with a very high mortality, but some malignancies in the pancreas have a better prognosis. These are carcinomas generated from the mucinous neoplasms. There are mainly two types of mucinous lesions in the pancreas: Intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasms (MCN). Some studies have also reported some increased frequency of extrapancreatic malignancies concurrent with a mucinous neoplasm. Methods: I have reviewed clinical trials about chronic pancreatitis, intraductal papillary mucinous neoplasms, mucinous cystic neoplasms and extrapancreatic malignancies, looking for associations between the different disorders. Results: A significant association between IPMN and extrapancreatic malignancies is reported in numerous clinical trials, but one trial contradicts this. This negative report is even comprised of the cohort with highest number of IPMN cases. It is concluded that IPMN is not associated with systemic carcinogenesis, except for pancreatic cancer. There is another trial with very similar design concluding on the very contrary: There is a positive significant association. Similarities and differences between these two publications are focused in the discussion. Conclusions: The report with negative conclusion on association between IPMN and extrapancreatic malignacises seems more elaborated, than the one with positive conclusion on associations. However, it is important to remember that all the other trials conclude that there is an association. This implies that awareness of extrapancreatic malignancies in patients with IPMN is mandatory