2020 Volume 53 Issue 3 Pages 230-238
We describe a case of a 65-year-old woman who was referred to our hospital because of a palpable mass in her upper abdomen. A mass with a mixture of cystic and solid components was identified by abdominal US. CT showed a round-shaped cystic tumor 7 cm in diameter on the head of the pancreas. Irregular solid components were observed in the cystic lumen and main pancreatic duct (MPD) distal to the tumor was dilated. MRI revealed that the fluid in the cyst was blood. On MRCP, dilated MPD was tapered by the tumor. Based on these findings, we suspected mucinous cyst neoplasm, intraductal papillary mucinous neoplasm, or solid pseudopapillary neoplasm, and performed pylorus-preserving pancreaticoduodenectomy. By postoperative pathological examination yielded a diagnosis of intraductal tubulopapillary neoplasm (ITPN). The patient had no postoperative complications and is alive after 3 years, without recurrence. We report a case of ITPN in the branch duct of the pancreas that showed atypical images.
