Intraductal papillary mucinous neoplasm presenting with recurrent pancreatitis: a report of a painful 3-decade-long history.

Intraductal papillary mucinous neoplasm represents the most common pancreatic cystic neoplasm and harbours significant malignant potential. Duct obliteration can lead to recurrent episodes of pancreatic inflammation mimicking acute and chronic pancreatitis. We report a case of a patient with multiple episodes of idiopathic pancreatitis occurring over a period of three decades. Following admission with severe upper gastrointestinal bleeding, the patient was diagnosed as having invasive pancreatic adenocarcinoma. Examination of the surgical specimen confirmed an intraductal papillary mucinous neoplasm with multiple foci of invasive adenocarcinoma. This case is of significant interest, highlighting the long delay until diagnosis seen in this situation. Intraductal papillary mucinous neoplasm should be considered in the presence of recurrent acute or chronic pancreatitis of unknown aetiology. 2016 BMJ Publishing Group Ltd.