# Fukuoka IPMN — Fukuoka international consensus imaging features for intraductal papillary mucinous neoplasm

> Stratifies pancreatic IPMN by worrisome features and high-risk stigmata on cross-sectional imaging to guide surveillance versus resection.

**Situação:** vigente · **Órgão:** Pâncreas · **Órgão emissor:** International Association of Pancreatology · **Versão:** 2017 · **Ano:** 2017

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: MRI, CT
- Fonte primária: Tanaka M, Fernandez-Del Castillo C, Kamisawa T, et al.. Revisions of international consensus Fukuoka guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas (2017) — https://pmc.ncbi.nlm.nih.gov/articles/PMC8713311/
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| no-risk-features | No worrisome features or high-risk stigmata | Neither high-risk stigmata nor worrisome features present on imaging: a branch-duct IPMN below the worrisome-feature thresholds (cyst <3 cm, no enhancing mural nodule, main pancreatic duct <5 mm, no concerning secondary features). | Imaging surveillance rather than resection; the source describes risk-stratified follow-up of cysts without worrisome features or high-risk stigmata. | Lowest malignancy risk category among IPMN; managed by surveillance. | PMC8713311, Table 2 (revised Fukuoka 2017): absence of the listed worrisome features and high-risk stigmata. | ✓ |
| worrisome-features | Worrisome features | Worrisome features: cyst size >=3 cm; enhancing mural nodule <5 mm; thickened/enhancing cyst walls; main pancreatic duct 5-9 mm; abrupt change in main-duct caliber with distal pancreatic atrophy; lymphadenopathy; elevated serum CA 19-9; acute pancreatitis attributable to the IPMN; and cyst growth rate >5 mm over 2 years. | Further assessment, typically endoscopic ultrasound (EUS), rather than immediate resection; the presence of worrisome features prompts closer evaluation. | Intermediate malignancy risk warranting additional workup. | PMC8713311, Table 2: worrisome features 'Cyst size >= 3 cm; Acute pancreatitis (due to IPMN); Enhancing mural nodule >= 5 mm; Thickened and enhancing cyst wall; MPD dilation 5-9 mm; Abrupt change of MPD caliber with distal pancreatic atrophy; Presence of lymphadenopathy; Elevated serum CA 19-9; Cyst growth rate > 5 mm/2 yr'. | ✓ |
| high-risk-stigmata | High-risk stigmata | High-risk stigmata: obstructive jaundice in a patient with a cystic lesion of the pancreatic head; enhancing mural nodule >=5 mm; main pancreatic duct >=10 mm; (and high-grade dysplasia or cancer on cytology). | Surgical resection is recommended for surgically fit patients with any high-risk stigmata. | Highest malignancy risk category; resection advised. | PMC8713311, Table 2: high-risk stigmata 'Jaundice; Enhancing mural nodule >= 5 mm; MPD >= 10 mm' (plus 'HGD or cancer on cytology'). | ✓ |

### Citações por categoria
- **no-risk-features**: Tanaka M, Fernandez-Del Castillo C, Kamisawa T, et al.. Revisions of international consensus Fukuoka guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas (2017) — https://pmc.ncbi.nlm.nih.gov/articles/PMC8713311/ · PMC8713311, Table 2 (revised Fukuoka 2017): absence of the listed worrisome features and high-risk stigmata.
- **worrisome-features**: Tanaka M, Fernandez-Del Castillo C, Kamisawa T, et al.. Revisions of international consensus Fukuoka guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas (2017) — https://pmc.ncbi.nlm.nih.gov/articles/PMC8713311/ · PMC8713311, Table 2: worrisome features 'Cyst size >= 3 cm; Acute pancreatitis (due to IPMN); Enhancing mural nodule >= 5 mm; Thickened and enhancing cyst wall; MPD dilation 5-9 mm; Abrupt change of MPD caliber with distal pancreatic atrophy; Presence of lymphadenopathy; Elevated serum CA 19-9; Cyst growth rate > 5 mm/2 yr'.
- **high-risk-stigmata**: Tanaka M, Fernandez-Del Castillo C, Kamisawa T, et al.. Revisions of international consensus Fukuoka guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas (2017) — https://pmc.ncbi.nlm.nih.gov/articles/PMC8713311/ · PMC8713311, Table 2: high-risk stigmata 'Jaundice; Enhancing mural nodule >= 5 mm; MPD >= 10 mm' (plus 'HGD or cancer on cytology').

## Referências cruzadas
- _fronteira compartilhada_ → [ACR Incidental Pancreatic Cyst — ACR incidental pancreatic cyst management](https://radcommons.laudos.ai/systems/acr-incidental-panc-cyst-2017.md) — Two frameworks for managing incidental pancreatic cystic lesions; thresholds for follow-up versus resection differ.

## Histórico de versões

| Data | Evento | Detalhe | Situação |
| --- | --- | --- | --- |
| 2017-07-01 | revised | International consensus Fukuoka guidelines for IPMN revised (2017). | confirmed |


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> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

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