Context: 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.
Case report: 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.
Conclusion: 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.