Wu GZ, Lu LN, Lin HP, Wang XY, Yu SA, Yu M. Laparoscopic management of intraductal oncocytic papillary neoplasm of the pancreas: Two case reports and review of literature. World J Gastrointest Surg 2025; 17(4): 105096 [DOI: 10.4240/wjgs.v17.i4.105096]
Corresponding Author of This Article
Min Yu, MD, Chief Physician, Professor, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Wucheng District, Jinhua 321000, Zhejiang Province, China. greendoctor@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Guo-Zhen Wu, Hai-Ping Lin, Shi-An Yu, Min Yu, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
Li-Na Lu, Department of Gastroenterology, Wenrong Hospital of Jinhua City, Jinhua 321000, Zhejiang Province, China
Xin-Yu Wang, Department of Radiology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
Co-first authors: Guo-Zhen Wu and Li-Na Lu.
Author contributions: Wu GZ wrote the manuscript; Lu LN participated in data collection; Lin HP and Wang XY helped revise the manuscript; Yu SA and Yu M designed the study; Wu GZ and Lu LN contributed equally to this work; All authors have read and approved the final manuscript.
Supported by the Zhejiang Medical Science and Technology Project, No. 2022KY1325 and No. 2023KY381.
Informed consent statement: Informed written consent were obtained from the patients for publication of these case reports and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Yu, MD, Chief Physician, Professor, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Wucheng District, Jinhua 321000, Zhejiang Province, China. greendoctor@163.com
Received: January 13, 2025 Revised: February 4, 2025 Accepted: March 3, 2025 Published online: April 27, 2025 Processing time: 76 Days and 4.2 Hours
Abstract
BACKGROUND
Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas is an extremely rare pancreatic tumor, with only sporadic cases reported in the literature. IOPN is difficult to diagnose and highly prone to misdiagnosis. IOPN carries a certain risk of progressing to invasive cancer. Surgical resection is the primary treatment for IOPN. According to the existing literature reports, the vast majority of patients with IOPN of the pancreas undergo open surgery, while only one case of laparoscopic surgery have been reported.
CASE SUMMARY
This report presents two cases of IOPN in elderly female patients, aged 60 and 61. Both patients were asymptomatic, and their pancreatic masses were discovered incidentally. Preoperative diagnosis of IOPN is challenging and prone to misdiagnosis. In the first case, the patient underwent a laparoscopic distal pancreatectomy and splenectomy. The surgical procedure spanned 342 minutes, with an estimated intraoperative blood loss of around 100 mL. The patient experienced an uneventful postoperative recovery and was discharged on the 8th postoperative day. For the second case, a laparoscopic pancreaticoduodenectomy was performed. The operation lasted for 431 minutes with an intraoperative blood loss of approximately 50 mL. The patient also demonstrated a favorable postoperative course and was discharged on the 24th postoperative day. Postoperative pathology and immunohistochemistry confirmed the diagnosis of IOPN. No recurrence was observed in either patient after follow-up periods of 8 and 10 months, respectively.
CONCLUSION
These cases demonstrate that laparoscopic surgery can be considered as one of the treatment options for IOPN of the pancreas.
Core Tip: Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas is extremely rare. The mechanism of the disease is not fully understood. Here, we reported 2 cases of pancreatic IOPN that were treated with laparoscopic surgery, covering its clinical manifestations, imaging findings, pathological morphological and immunophenotype, clinical treatment and prognosis, aiming to provide references for clinicians and improve the level of diagnosis and treatment of similar cases. Since a certain proportion of cases may be associated with invasive cancer, surgery is the preferred treatment. Laparoscopic surgery can be considered as one of the treatment options for IOPN of the pancreas.
