Recurrent pancreatitis by invasive IPMN in young patient: case report and review of management strategies
Alberto Torrisi, Roberto Cantella, Danilo Paolo Cannizzaro, Guido Basile, Martina Reina, Giuseppe Angelo ReinaIntroduction:
Intraductal papillary mucinous neoplasm (IPMN) is a cystic lesion of the pancreas connected to the ductal system. It carries a risk of malignant transformation, especially in the main-duct form (MD-IPMN). Most cases occur in patients older than 60 years, but early presentation is possible and may indicate a genetic condition that should be investigated. The evolution of diagnostic techniques and updates to guidelines allow risk stratification and management based on high-risk stigmata and worrisome features.
Case presentation:
A 31-year-old woman presented with acute pancreatitis. Clinical and radiological evaluations led to the diagnosis of main-duct IPMN. After surgical resection, high-grade dysplasia with diffuse foci of micro-invasive carcinoma was found and graded as PanIN-3. A genetic evaluation was recommended in light of the combined findings of young age and aggressive histopathology.
Discussion:
This rare clinical case highlights the possibility of early-onset malignant conditions. A thorough diagnostic workup in young patients with pancreatitis, especially if of non-lithiasic origin, remains essential for correct therapeutic decision-making. It has been demonstrated that survival rates vary significantly between low-grade and invasive histopathologic types. This underscores the importance of early identification and timely treatment. Laparoscopic pancreatectomy has proven to be a valid approach for achieving a favorable prognosis.
Conclusion:
This clinical case emphasizes the role of early diagnosis and appropriate therapeutic management. In aggressive forms, it highlights the need for precise surgical intervention and long-term multidisciplinary surveillance. This case contributes to the evolving understanding of IPMN in younger populations and supports the ongoing refinement of guidelines.