Most reported cases of intraductal papillary
mucinous neoplasms (IPMNs) originate from
Wirsung's duct or their branches. IPMNs arising from
Santorini's duct and its branches have rarely been reported. Eight cases of IPMN arising from
Santorini's duct have been published worldwide. However, these cases are associated with incomplete type of
pancreas divisum. Recently, one
report of IPMN with complete absence of
Wirsung's duct has been reported. This
patient was a 57-year-old
woman who was admitted to the
hospital due to progressive
jaundice. On
endoscopic retrograde cholangiopancreatography, there was a severely bulging
ampulla of Vater and patulous
minor papilla draining mucinous material and a cystic lesion communicating with the dilated
Santorini's duct without any
communication with
Wirsung's duct. A
pancreaticoduodenectomy was performed and the pathologic examination of resected specimen showed no evidence of
Wirsung's duct, but an IPMN arising from
Santorini's duct with peripancreatic
lymph node metastasis. Herein, we
report a case of invasive IPMN arising from pancreatic
head without ventral
pancreatic duct with a
review of the relevant
literatures.