High-grade and Invasive Intraductal Papillary Mucinous Neoplasm of the Pancreas with STK11 Aberration Having Undergone Pancreatic Resection Three Times for Metachronous Intrapancreatic Recurrences: A Case Report and Review of the Literature
A 56-year-old woman with high-grade or invasive intraductal papillary mucinous neoplasm (IPMN) underwent 3 pancreatic surgeries for initial and recurrent IPMN lesions. Immunostaining and genetic analyses of all lesions revealed a consistent mutation in KRAS and loss of serine/threonine kinase 11 (STK11), indicating the same origin of these lesions and the possibility of intraductal dissemination. Other immunostaining findings, such as mucin expression and a high Ki-67 labeling index, were consistent among all the lesions and supported their malignant potential. IPMNs with loss of STK11 may benefit from tailored follow-up of the remnant pancreas due to their high likelihood of recurrence through intraductal spread.
Authors
- Takashi Tsuchiya (ORCID: https://orcid.org/0000-0003-2594-1811)
- Toru Furukawa (ORCID: https://orcid.org/0000-0002-1083-2324)
- Keisuke Yonamine (ORCID: https://orcid.org/0000-0003-1121-7320)
- Taito Itoh (ORCID: https://orcid.org/0000-0002-2518-3865)
- Hiroaki Kusunose (ORCID: https://orcid.org/0000-0002-8563-9342)
- Takashi Sawai (ORCID: https://orcid.org/0000-0001-5983-6214)
- Shinsuke Koshita (ORCID: https://orcid.org/0000-0001-6880-5532)
- Yuko Omori (ORCID: https://orcid.org/0009-0004-8285-5340)
- Takahisa Ogawa (ORCID: https://orcid.org/0000-0002-8934-6555)
- Hideyuki Anan (ORCID: https://orcid.org/0000-0003-4113-6361)
- Masaya Oikawa (ORCID: https://orcid.org/0000-0001-7809-9838)
- Fumisato Kozakai (ORCID: https://orcid.org/0000-0002-5890-3531)
- Yutaka Noda (ORCID: https://orcid.org/0000-0001-6568-6590)
- Kento Hosokawa (ORCID: https://orcid.org/0009-0003-0112-2368)
- Toshitaka Sakai (ORCID: https://orcid.org/0000-0002-7450-8478)
- Haruka Okano (ORCID: https://orcid.org/0000-0002-0287-1120)
- Yoshihide Kanno (ORCID: https://orcid.org/0000-0002-2044-5483)
- Kazuaki Miyamoto (ORCID: https://orcid.org/0000-0001-8313-1396)
- Kei Ito (ORCID: https://orcid.org/0000-0002-0023-7919)
Institutions
- Tohoku University (JP)
- Sendai Medical Center (JP)
- Teine Keijinkai Hospital (JP)
- Yokohama City University (JP)
Publication Details
- Journal
- Internal Medicine
- Published
- 2025-05-14
- DOI
- https://doi.org/10.2169/internalmedicine.5076-24
- Primary Topic
- Pancreatic and Hepatic Oncology Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00