Intraductal papillary mucinous neoplasm with pseudomyxoma peritonei: a case report

Pseudomyxoma peritonei (PMP) secondary to pancreatic intraductal papillary mucinous neoplasms (IPMNs) is extremely rare, making diagnosis and treatment of this condition challenging.

We present a case of a 67-year-old gentleman diagnosed with a malignant degeneration of IPMN, treated with neoadjuvant systemic therapy, followed by total pancreatectomy. Twelve months after his surgery, he was found to have two capsular hepatic lesions on surveillance imaging. Biopsy confirmed pseudomyxoma peritonei, and the patient subsequently underwent cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

This unique case highlights the importance of post-operative surveillance for surgically resected IPMNs and understanding the role for CRS and HIPEC as an option for treating PMP secondary to IPMNs.

Although PMP secondary to IPMN is extremely uncommon, it can occur months to years after initial surgery, and for patients in whom complete cytoreduction is achievable, CRS and HIPEC may represent a viable treatment option.