Papillary-cystic neoplasm of the pancreas

A case of an unusual pancreatic tumor with a characteristic papillary-cystic microscopic morphology is presented. Review of four previously reported similar cases suggests a distinct clinical picture of a large abdominal mass occurring in a young person which apparently, after resection, does not rapidly recur. The histopathology of this tumor consists of papillary and cystic patterns, regular homogeneous cells with few mitoses, glassy eosinophilic cytoplasm, and mucin and PAS positivity. Ultrastructural detail, including eccentric nucleoli, numerous mitochondria, sparse endoplasmic reticulum, and little evidence of secretory activity, suggests a duct cell origin for this rare tumor.