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Case Reports in Gastrointestinal Medicine
Volume 2017, Article ID 8705195, 5 pages
Case Report

Association of Chronic Pancreatitis and Malignant Main Duct IPMN: A Rare but Difficult Clinical Problem

1Departamento Medicina, Sección Gastroenterología, Hospital Clínico Universidad de Chile, Santiago, Chile
2Clínica Santa María, Santiago, Chile
3Fundación Arturo López Pérez, Santiago, Chile
4Universidad Andres Bello, Santiago, Chile
5Universidad de los Andes, Santiago, Chile

Correspondence should be addressed to Zoltán Berger; moc.liamg@natloz.regreb

Received 12 September 2016; Accepted 26 January 2017; Published 22 February 2017

Academic Editor: Gregory Kouraklis

Copyright © 2017 Zoltán Berger et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We report the case of a 70-year-old woman who consulted for recurrent short episodes of mild-to-moderate abdominal pain. Dilated main pancreatic duct was seen on CAT scan and magnetic resonance, with multiple calcifications and intraductal stones, typical in CP. However, for a more pronounced cystic dilatation in the pancreatic head, we could not exclude the coexistence of a main duct IPMN. ERCP was performed, with pancreatic sphincterotomy and extraction of pancreatic stones, but, at the same time, mucin extrusion was seen from the dilated duct through the papilla. Pancreatoduodenectomy was performed. Surgery and histology confirmed malignant IPMN with the typical image of chronic pancreatitis and intraductal stones in the vicinity. The patient is doing well 4 years after the surgery, without recurrence of the malignant disease, with changes of chronic pancreatitis in the pancreatic remnant. This paper discusses the possible relationships between the two entities and emphasizes the need of differential diagnosis.