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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, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Clonal evolution & minimal residual disease.
Shares GNAS, RNF43, SMAD4, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors.
Shares RNF43, SMAD4, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Clonal evolution & minimal residual disease.
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 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 Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Clonal evolution & minimal residual disease, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Pancreatic ductal adenocarcinoma.