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In 61 patients who had both a cyst and a pancreatic cancer removed, the two were genetically related in about half and unrelated in a fifth, so a cyst can be an innocent bystander to a cancer arising elsewhere.
All available patients with co-occurring IPMN and invasive intrapancreatic carcinoma over ten years at a single institution were analysed: DNA from the carcinoma, adjacent IPMN and distant IPMN underwent targeted next-generation sequencing of pancreatic cancer driver genes to infer relatedness. Of 61 patients with IPMN and ductal adenocarcinoma, 51% were likely related and 18% likely independent; all 13 IPMN and colloid carcinoma pairs were likely related. Striking genetic heterogeneity was found within IPMNs even for well-characterised driver genes.
Risk stratification of a cyst cannot assume the nearby cancer came from it, and the whole gland stays at risk after cyst resection.
Shares GNAS, SMAD4, Clonal evolution & minimal residual disease, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors.
Shares GNAS, RNF43, SMAD4, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors.
Shares RNF43, SMAD4, Clonal evolution & minimal residual disease, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors.
Shares GNAS, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Pancreatic ductal adenocarcinoma.
Shares GNAS, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, KRAS.
Shares SMAD4, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, TP53, KRAS.
Shares GNAS, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, KRAS.
Shares Clonal evolution & minimal residual disease, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Pancreatic ductal adenocarcinoma.