Pancreatic Colloid Carcinoma with Background Intraductal Papillary Mucinous Neoplasm: A Case Report

Document Type

Article

Publication Date

5-2026

Abstract

Background: Pancreatic colloid carcinoma, also known as mucinous noncystic carcinoma, is a type of invasive pancreatic ductal adenocarcinoma (PDA) that represents less than 1% of pancreatic tumors. There are two types of invasive PDA that arise in the setting of IPMN: tubular reflecting a pancreatobiliary type that is usually smaller at presentation; and colloid reflecting an intestinal type that can be up to 16 cm in size at presentation. Colloid carcinoma in the background of an IPMN has a superior prognosis to that of a standard pancreatic ductal adenocarcinoma with a 5-year survival rate of 40–60% instead of 10–25% which is due to its lower rate of advanced T stage, metastasis, and neurovascular invasion. Due to its rarity, there is still a paucity of data regarding specifics for prognostic indicators or treatment recommendations and patient outcomes. Case: We present a case of colloid carcinoma originally suggestive of IPMN on preoperative imaging with a suspected poor prognosis. The patient, with a family history of pancreatic cancer, initially presented with abdominal pain and jaundice with further history notable for pale stools. Workup revealed a heterogeneous mass in the pancreatic head with near abutment of the SMV and portal vein concerning for neoplasm with both biliary and pancreatic ductal dilation. The patient underwent a total pancreatectomy with splenectomy with Whipple reconstruction. Final surgical pathology found the mass to be a colloid carcinoma measuring 6.3 cm in greatest dimension along with background IPMN and chronic pancreatitis at the margins, with all sampled nodes being negative for metastasis. The patient is recovering well postoperatively and is currently alive awaiting further treatment with chemotherapy. Conclusions: There is no established adjuvant chemotherapy regimen for pancreatic colloid carcinoma due to the rarity of the disease. Timely and accurate diagnosis of colloid carcinoma can provide patients with a better initial prognosis, and guide management decisions, while also preventing any treatment delays or inappropriate referrals for hospice. Due to its unique pathology and absence of large prospective studies, there are no formal guidelines for management or surveillance imaging. This case highlights the need for greater understanding of pancreatic colloid carcinoma to better guide adjuvant therapy, surveillance, and goal directed care discussions.

Comments

This abstract was published in Surgical Endoscopy, Volume 40, Issue 2 Supplement.

The published version is available at https://dx.doi.org/10.1007/s00464-026-12851-0.

Copyright © 2026.

Publication Title

Surgical Endoscopy

This document is currently not available here.

Share

COinS