Intraductal tubulopapillary neoplasm of the pancreas presenting as recurrent acute pancreatitis: A case report

Abstract

HighlightsIntraductal tubulopapillary neoplasms (ITPNs) is a rare malignant lesion.The patient was diagnosed as causing acute pancreatitis by ITPN.There are only 5 cases reported about ITPNs presenting as acute pancreatitis.It is important to diagnose that the cause of acute pancreatitis is ITPN.

Intraductal tubulopapillary neoplasm (ITPN) of the pancreas: a distinct entity among pancreatic tumors

“…After applying our inclusion criteria, 68 articles were included in the systematic review (Figure S1). 11–78 …”

Total Pancreatectomy with Splenectomy for Multifocal Intraductal Tubulopapillary Neoplasm (ITPN) of the Pancreas Associated with Invasive Component: Report of a Rare Case

“…About one-third of patients were asymptomatic and ITPN was an incidental finding [ 2 , 5 – 8 , 10 , 19 ]. ITPN has also been associated with episodes of recurrent acute pancreatitis and should be considered in the differential diagnosis of idiopathic acute pancreatitis [ 20 ]. The intraluminal growth of the neoplasm inside the pancreatic duct may cause slow obstruction and obstructive chronic pancreatitis [ 11 ].…”

“…Two of them were alive and disease-free 15 and 19 months after surgery [ 2 , 23 ], whereas the third was diagnosed with hepatic metastases in the fourth postoperative month [ 18 ]. There were also 4 reported cases of patients from Japan with pancreatic ITPN who received postoperatively S-1 (tegafur-gimeracil-oteracil potassium) [ 9 , 20 , 30 , 31 ]. S-1 plays a key role in the treatment of pancreatic cancer in Japan besides gemcitabine [ 32 ].…”

“…Three of these cases were diagnosed with recurrence of the primary disease at 15 months [ 30 ], 34 months [ 31 ] and 16 years after pancreatoduodenectomy [ 9 ]. The fourth was alive and disease-free in the first postoperative year [ 20 ].…”

Intraductal Tubulopapillary Neoplasm Diagnosed Before Surgery: A Case Report

“…Regarding the "cork-of-wine bottle sign," Sakamoto et al noted the following: in the case where the tumor occupies the entire lumen of the pancreatic duct, MRI does not show the sign, it rather presents a ductal interruption. Therefore, the sign is not always a confirmed finding depending on the size and the degree of the lesion progression [14]. Consequently, the "two-tone-duct sign" and the "cork-of-wine bottle sign" cannot be considered useful findings in differentiating ITPN from PDAC.…”