title: Obstructive chronic pancreatitis and/or intraductal papillary mucinous neoplasms (IPMNs): a 21-year long case report.
abstract: BACKGROUND
  Intraductal papillary mucinous neoplasms of the pancreas (IPMNs), usually present with a picture of chronic pancreatitis and must be considered within the differential diagnosis of this condition.
  
  
  METHODS
  We report a long history of a 58-year-old male who presented with recurrent attacks of pancreatitis. He was treated for chronic pancreatitis until the age of 78 when the diagnosis of IPMN was made, but radical treatment was not possible and he was managed palliatively. The patient died of sepsis and multi-organ failure 21 years following his first presentation.
  
  
  CONCLUSIONS
  This case highlights possible pitfalls in the diagnosis and treatment of IPMNs, suggests a very long natural history, proposes possible palliative treatment in selected cases and reflects about IPMNs biological position in the chronic pancreatitis-ductal adenocarcinoma chain.
authors.affiliation: Department of Surgical and Gastroenterological Sciences, Policlinico GB Rossi, University of Verona, Verona, Italy. abu_hlal@yahoo.com
authors.forename: Mohammed
authors.initials: M
authors.lastname: Abu-Hilal
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvia
authors.forename: Andrea
authors.initials: A
authors.lastname: Casaril
authors.forename: Neil William
authors.initials: NW
authors.lastname: Pearce
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.forename: Paola
authors.initials: P
authors.lastname: Capelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Nicoli
mesh_terms: D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002908:Chronic Disease; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010195:Pancreatitis / Q000209:etiology*; D014057:Tomography, X-Ray Computed