2023 Volume 38 Issue 2 Pages 173-180
A 60-year-old man presented with worsening diabetes. Computed tomography scan showed a mass in the tail of the pancreas. Distal pancreatectomy with lymph node dissection was performed with a preoperative diagnosis of pancreatic cancer. Pathological findings showed pancreatic intraductal tubulopapillary carcinoma, invasive pN1b (9/31+), pT3N1bM0 pStage IIB. The postoperative course was uncomplicated. Yamaguchi first described intraductal tubulopapillary neoplasm (ITPN) in 2009 as a rare pancreatic neoplasm. ITPN can be difficult to distinguish from other intraductal tumors and typical pancreatic cancer, and it was challenging to make a preoperative diagnosis for this patient. Since tumor progression is relatively slow, lymph node and distant metastases are rare. Lymph node metastases are reported to be present in about 3.4%. In this patient, lymph node metastases were present, and close follow-up is necessary.
