title: Can an intraductal papillary mucinous tumor be a potential indicator of concurrent adenocarcinoma of the pancreas?
abstract: BACKGROUND
  Despite the recent progress of diagnostic and therapeutic modalities, survival rates of pancreatic adenocarcinoma remain poor, mainly due to late diagnosis.
  
  
  METHODS
  We report the case of a 56-year-old man who was diagnosed with a symptomatic intraductal papillary mucinous tumor of the pancreas located in the uncus. This tumor was associated with a concurrent stenosis of the isthmic pancreatic duct which resulted in a distal dilation. A Whipple procedure was performed. During the procedure, a concomitant adenocarcinoma was diagnosed 2 cm from the primary intraductal papillary mucinous tumor, causing the isthmic stenosis. A second resection was then performed to the left of the pancreatic isthmus, and adjuvant chemotherapy was performed. The patient is well and without any sign of recurrence 7 months after surgery.
  
  
  CONCLUSIONS
  We discuss the possibility that intraductal papillary mucinous tumors may be a "red flag" enabling earlier diagnosis of a concurrent pancreatic adenocarcinoma arising in another area of the pancreas.
authors.affiliation: Department of Surgery, Haut Leveque Hospital, Avenue Magellan, 33000 Bordeaux, France. julienjarry@hotmail.com
authors.forename: Julien
authors.initials: J
authors.lastname: Jarry
authors.forename: Genevieve
authors.initials: G
authors.lastname: Belleannee
authors.forename: Alexandre
authors.initials: A
authors.lastname: Rault
authors.forename: Antonio
authors.initials: A
authors.lastname: Sa Cunha
authors.forename: Denis
authors.initials: D
authors.lastname: Collet
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis*; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis*; D002291:Carcinoma, Papillary / Q000175:diagnosis*; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*