by a stricture or stone with upstream dilatation of the duct. These clinical features which have similarities with IPMN particularly when the stone load is sparse in tropical pancreatitis. This makes accurate preoperative diagnosis of IPMN difficult. Rarely both these disease forms can coexist as well [6]. This retrospective study is a descriptive analysis of the diagnosis, surgical treatment and pathological details of these patients and the difficulties in diagnosing IPMN in areas where tropical pancreatitis is prevalent. MethodsFrom May 2009 to October 2014, twenty-four patients with IPMN were operated in our unit. There were 16 males and 8 females with median age of 58 years. Abdominal pain, weight loss and or jaundice were the clinical presentation. Patients were investigated using ultrasonography, contrast enhanced CT scan and endosonography (EUS). EUS guided FNAC were obtained from suspicious lesions. EUS guided FNA was used in cases with mass lesions/mural nodules. CT scan findings were suggestive of IMPN in 6 (25%) of patients and that in endosonography was 13 (54%) ( Table 1). Research Article AbstractIntraductal Papillary Mucinous Neoplasm of Pancreas (IPMN) is being more frequently diagnosed and treated worldwide as clinicopathological features of this entity is well described. The entity IPMN was included in the WHO classification system in 1996 and is classified as branch duct IPMN and main duct disease essentially based on radiological features. This disease is considered relatively rare in India, except for a couple of published case reports. Tropical pancreatitis is a form of idiopathic chronic pancreatitis seen in tropical Asia and Africa. This entity is characterised by obstruction of the pancreatic duct by a stricture or stone with upstream dilatation of the duct, the features which have similarities with IPMN making accurate preoperative diagnosis of IPMN difficult. This article describes the diagnosis, surgical treatment and pathological details of these patients and the difficulties in diagnosing IPMN in areas where tropical pancreatitis is prevalent.

Introduction: Solid pseudopapillary neoplasm is a unique enigmatic disease typically affecting young females. Being a low-grade neoplasm surgical resection is often curative. Rare cases (5-15%) present with distant metastasis. Only 2% has lymph nodal metastasis. This is a case report of metastatic SPN with both visceral and lymph nodal involvement. The work has been reported in line with the SCARE criteria. Case Presentation: The authors present a case of metastatic SPN in an 18-year-old female who came with an abdominal lump. Contrast enhanced CT abdomen findings were in favour of huge SPN arising from pancreatic tail. The prime concern was the coexistence of bilobar liver metastasis predominantly involving right lobe. The complexity of surgical resection along with metastatectomy in a young female was herculean. This clinical dilemma was tackled with staged resection. Conclusion: Even in metastatic SPN a reasonable survival can be achieved by surgical debulking. We emphasize the importance of aggressive approach in operable metastatic SPN.

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