MRI finding of IPMNs: anyone have them turn to cancer?

Hello @hen and welcome to Mayo Connect. Many of us, myself included, have a diagnosis of IPMNs, without a pancreatic cancer diagnosis. I can certainly understand your concern, though.
Any problem with the pancreas or live tends to bring about very worrisome scenarios. Are you seeing a GI specialist for follow up?

As you read the following discussions on this topic you will see that follow up MRIs are usually done and often an EUS (endoscopic ultrasound) is also done to better view the pancreas. I would encourage you to read the following discussions and then ask questions of those who have posted by clicking on "Reply" under the post.

--IPMN with Symptoms
https://connect.mayoclinic.org/discussion/ipmn-with-symptoms/
--Cyst on Pancreas
https://connect.mayoclinic.org/discussion/cyst-on-pancreas/?commentsorder=newest#chv4-comment-stream-header
Please remember that you have doubts or questions about the care you are currently receiving you can always seek a second opinion. Have you considered getting a second opinion?

Hi Everyone
My Dr. sent me CA19-9 bloodwork due to multiple IPMN'S and to get a baseline. It came back < 27. From what I have read this means no cancer? I haven't heard from my Dr. yet.

It's a good result but doesn't mean "no cancer." There are some people who never get elevated CA19-9 or produce any at all despite having pancreatic cancer.

One thing I've learned from many experiences in different fields is that, "Absence of evidence is not evidence of absence." With pancreatic cancer, it's important to look at things from as many different angles as possible.

Enjoy the fact that you have a doctor who's ordering tests, and that you got an encouraging result on the first one. If you're experiencing pancreas issues now, it's worth getting genetic (germline) testing done to see if you've inherited any mutations that increase your risk of getting PC or other types of cancer.

The vast majority of IPMN’s are found to be benign and will never cause issue. When they occur in branch ducts of the pancreas, and no worrisome features which is the vast majority, they will be surveilled likely on a yearly schedule up to two years for growth. They can grow up to 3 cm before they could occlude a branch duct and trigger pancreatitis. Surgical removal is usually warranted.

For IPMN’s in in the main duct or communicate with a main duct-meaning they are at a point where part of the IPMN is extended into the main duct and awash with pancreatic juice of a higher volume, the limit in size before intervention is 1 cm or if there are concerning features. At that point, surgery is considered. Surveillance would likely be every six months for the first two years.

CA19-9 is in the normal range and the mast majority of cysts do not produce CA19-9. That marker is not specific for pancreatic cancer as elevation can occur in benign conditions of the GI tract, pancreatitis and even lung infections. A value of 27 U/ml is not indicative of anything.

I have IPMN’s and the first thing I did was to go to a center that specializes in IPMN’s with a clinic You may want to consider enrolling in a clinical study that is monitoring the two types of surveillance methods in use to determine the method that is best. There are sites throughout the US, and a few in Canada and Korea.

IPMN EA2185 CLINICAL STUDY
https://ecog-acrin.org/clinical-trials/ea2185-pancreas-cancer-prevention/

My husband's ca19-19 was so high last time 16,000!!
He hadn't had chemo for several months because he was going every day for radiation which I guess didn't help except keep his tumor stable
So he restarted chemo 2 weeks ago so it will be interesting to see if it comes down!!!✝️