Recurrent pancreatitis due to intraductal papillary mucinous neoplasm in a young adult

Abstract

A young adult male presented with recurrent pancreatitis and a 2.2 cm mixed duct intraductal papillary mucinous neoplasm (IPMN) located in the pancreatic body. Our patient presented at age 21 with his second hospitalization for acute pancreatitis within a year. A mixed duct IPMN with main ductal dilation was identified, which prompted additional workup. Based upon the findings the patient was counseled regarding the risks and benefits of surveillance versus surgery. The patient elected to undergo a robotic-assisted laparoscopic distal pancreatectomy and splenectomy. Final pathology revealed an IPMN involving branch and main pancreatic ducts with low and focally high-grade dysplasia. IPMNs are increasingly being identified. Consensus guidelines generally propose surveillance, but management in young adults can be complex. Herein we present the second youngest reported case and highlight the continued need for consensus management guidelines.