Papillary adenoma of the pancreas with excessive mucin secretion

A 68-year-old woman with papillary adenoma of the pancreas with excessive mucin secretion is reported. The patient was initially diagnosed as having chronic pancreatitis because of a history of repeated attacks of pancreatitis and localized dilatation of the main pancreatic duct. Four years later, endoscopic retrograde pancreatography showed markedly diffuse dilatation of the entire main pancreatic duct with amorphous filling defects of mucin. Excretion of mucin was observed through the enlarged orifice of Vater's ampulla. The patient was treated with distal pancreatectomy, and papillary adenoma with abundant mucin in the cytoplasm was histologically demonstrated. We describe unique clinical features of "mucin-producing pancreatic tumor" and discuss an important role of endoscopic retrograde pancreatography in the diagnosis.