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Intraductal Papillary Mucinous Neoplasia in a Case of Complete Pancreatic Divisum - A Rare Combination

Ashish Kumar Jha, Amrita Chakrabarty, Usha Goenka and Mahesh Kumar Goenka

Intraductal Papillary Mucinous Neoplasms (IPMNs) are intraductal mucin-producing cystic neoplasms of the pancreas. Most of these neoplasms are benign but chances of malignant transformation need to be ruled out. These neoplasms have usually been reported from the Wirsung’s duct or its branches. IPMN arising from the the Santorini’s duct is a rare condition. Such tumors originating from the Santorini’s duct are usually associated with incomplete type of pancreatic divisum. IPMNs associated with complete pancreatic divisum have rarely been reported. Imaging techniques including CT scan and MRCP and fluid analysis enabled by SpyGlass pancreatoscopy are the key to diagnosis of IPMN. Treatment usually comprises surgical resection and prognosis depends on malignant changes and lymph node status.