Radiology: Intraductal papillary mucinous neoplasm (IPMN)

Intraductal papillary mucinous neoplasms (IPMN) are frequently discovered during routine abdominal imaging.  Though most are benign, like colonic polyps they have the potential to grow and become dysplastic/malignant.  The presence of IPMN is not itself a contraindication for liver transplantation, nor does it have to be surgically removed prior to transplant.

Of course, certain features of IPMN suggest more advanced stage of dysplasia, and such cases should be reason for concern during a liver transplant evaluation.  CEA and Ca 19-9 are biomarkers that can be helpful in distinguishing benign from malignant.  Radiologic features that are more worrysome include main duct lesion (vs. side branch), larger size, presence of septations and thicker walls. 

In the radiograph above, note the cystic lucencies in the head of the pancreas, representing IPMN.

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