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Recent findings on shared genetic alterations in IPMN and related cancers are reviewed to define the IPMN–CRC association. Once IPMN is diagnosed, CRC should receive special consideration. With no established colorectal screening guidance, patients are treated as high-risk and more rigorous CRC surveillance is recommended.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/synchronous-manifestation-of-colorectal-cancer-and-intraductal-papillary-mucinous-neoplasms/377982/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/synchronous-manifestation-of-colorectal-cancer-and-intraductal-papillary-mucinous-neoplasms/377982.png","ImageObject",300,407,{"name":92,"@type":93},"Jacob","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is synchronous colorectal cancer considered in patients with IPMN?","Question",{"text":112,"@type":113},"High rates of extrapancreatic malignancies, particularly colorectal cancer, are detected in IPMN patients. The review highlights an association between IPMN and CRC and recommends special consideration for CRC after IPMN diagnosis.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What does the review suggest about genetic alterations linking IPMN and CRC?",{"text":117,"@type":113},"The mini-review emphasizes shared genetic alterations that could explain synchronous manifestation. Mutations in GNAS and KRAS are mainly expressed in IPMN, while other related genes show lower mutation frequencies.",{"name":119,"@type":110,"acceptedAnswer":120},"Is there a guideline for colorectal screening in IPMN patients?",{"text":121,"@type":113},"No specific guidelines are described for colorectal screening programs for patients with IPMN. The review recommends treating these patients as high-risk and implementing a more rigorous colorectal surveillance program.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},377982,1790269495,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962084931830,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","| W | J | C | C | World Journal of\u003Cbr>Clinical Cases |\n| --- | --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Clin Cases 2023 May 26; 11(15): 3408-3417  \nDOI: 10.12998/wjcc.v11.i15.3408 ISSN 2307-8960 (online)  \nMINIREVIEWS  \nSynchronous manifestation of colorectal cancer and intraductal papillary mucinous neoplasms  \nMilko Bozhidarov Mirchev, Irina Boeva, Monika Peshevska-Sekulovska, Veselin Stoitsov, Milena Peruhova  \nSpecialty type: Medicine, research and experimental  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s scientific quality classification  \nGrade A (Excellent): 0  \nGrade B (Very good): B, B  \nGrade C (Good): C  \nGrade D (Fair): 0  \nGrade E (Poor): 0  \nP-Reviewer: Emran TB,  \nBangladesh; Fujimori S, Japan  \nReceived: January 10, 2023  \nPeer-review started: January 10, 2023  \nFirst decision: February 8, 2023  \nRevised: February 26, 2023  \nAccepted: April 17, 2023  \nArticle in press: April 17, 2023  \nPublished online: May 26, 2023  \nMilko Bozhidarov Mirchev, Irina Boeva, Veselin Stoitsov, Milena Peruhova, Department of Gastroenterology, Heart and Brain Hospital, Burgas 8000, Bulgaria  \nMonika Peshevska-Sekulovska, Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria  \nCorresponding author: Milena Peruhova, MD, Assistant Professor, Department of Gastroenterology, Heart and Brain Hospital, Zdrave 1 st, Burgas 8000, Bulgaria.  \n[mperuhova@gmail.com](mperuhova@gmail.com)  \nAbstract  \nHigh rates of extrapancreatic malignancies, in particular colorectal cancer (CRC), have been detected in patients with intraductal papillary mucinous neoplasm (IPMN) . So far, there is no distinct explanation in the literature for the development of secondary or synchronous malignancies in patients with IPMN. In the past few years, some data related to common genetic alterations in IPMN and other affiliated cancers have been published. This review elucidated the association between IPMN and CRC, shedding light on the most relevant genetic alterations that may explain the possible relationship between these entities. In keeping with our findings, we suggested that once the diagnosis of IPMN is made, special consideration of CRC should be undertaken. Presently, there are no specific guidelines regarding colorectal screening programs for patients with IPMN. We recommend that patients with IPMNs are at high-risk for CRC, and amore rigorous colorectal surveillance program should be implemented.  \nKey Words: Colorectal cancer; Intraductal papillary mucinous neoplasm; Genetic alterations; Extrapancreatic malignancies; Synchronous neoplasms  \n©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.  \n WJCC  [https://www.wjgnet.com](https://www.wjgnet.com) 3408 May 26, 2023  Volume 11  Issue 15   \nMirchev MB et al. Synchronous CRC and IPMN  \nCore Tip: In this mini-review, we highlighted the genetic alterations that occur in intraductal papillary mucinous neoplasm (IPMN) and colorectal cancer to understand common genetic or epigenetic risk factors that could explain their synchronous manifestation. The process of malignant transformation in both entities is complex, but some distinctive features of IPMN lesions are linked with their genetic heterogeneity. Specific mutations in GNAS and KRAS are mainly expressed in IPMN. A significantly lower frequency of mutations is detected in other cancer-related genes, such as SMAD4, PI3KCA, PTEN, and BRAF.  \nCitation: Mirchev MB, Boeva I, Peshevska-Sekulovska M, Stoitsov V, Peruhova M. Synchronous manifestation of colorectal cancer and intraductal papillary mucinous neoplasms. World J Clin Cases 2023; 11(15): 3408-3417 URL: [https://www.wjgnet.com/2307-8960/full/v11/i15/3408.htm](https://www.wjgnet.com/2307-8960/full/v11/i15/3408.htm)  \nDOI: [https://dx.doi.org/10.12998/wjcc.v11.i15.3408](https://dx.doi.","cbCaipMzHA5f9uJ6","https://ap.wps.com/l/cbCaipMzHA5f9uJ6","pdf",1110382,11,"English","# Abstract\n# Core Tip\n# Introduction\n## IPMN features and classification\n## IPMN associated malignancies and CRC incidence\n## Genetic and epigenetic mechanisms","[{\"question\":\"Why is synchronous colorectal cancer considered in patients with IPMN?\",\"answer\":\"High rates of extrapancreatic malignancies, particularly colorectal cancer, are detected in IPMN patients. The review highlights an association between IPMN and CRC and recommends special consideration for CRC after IPMN diagnosis.\"},{\"question\":\"What does the review suggest about genetic alterations linking IPMN and CRC?\",\"answer\":\"The mini-review emphasizes shared genetic alterations that could explain synchronous manifestation. Mutations in GNAS and KRAS are mainly expressed in IPMN, while other related genes show lower mutation frequencies.\"},{\"question\":\"Is there a guideline for colorectal screening in IPMN patients?\",\"answer\":\"No specific guidelines are described for colorectal screening programs for patients with IPMN. The review recommends treating these patients as high-risk and implementing a more rigorous colorectal surveillance program.\"}]","Synchronous manifestation of colorectal cancer and intraductal papillary mucinous neoplasms | PDF",1790227869,28]