{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:47:14Z","timestamp":1787161634937,"version":"build-2736575974"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012330","name":"Okayama University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012330","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin J Gastroenterol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We herein report a case of pancreatic ductal adenocarcinoma (PDAC) that developed within the pancreatic duct and was initially diagnosed as an intraductal tubulopapillary neoplasm (ITPN). A 76-year-old man presented with weight loss and main pancreatic duct dilation. The imaging studies revealed a 30-mm hypovascular tumor within the main duct of the pancreatic head. An endoscopic examination with a biopsy revealed high-grade atypical epithelial cells with immunostaining patterns suggestive of ITPN. Following robot-assisted pancreaticoduodenectomy, postoperative pathology revealed conflicting features: nodular\/cribriform infiltrations typical of ITPN and non-lobular replacement with scattered infiltrations characteristic of PDAC. A comprehensive genomic profiling test detected\n                    <jats:italic>KRAS<\/jats:italic>\n                    and\n                    <jats:italic>TP53<\/jats:italic>\n                    mutations, leading to the final diagnosis of PDAC (fT3N1aM0, stage IIB). The patient received adjuvant S-1 chemotherapy and remained recurrence-free for 15\u00a0months post-surgery. This case highlights the diagnostic challenges of differentiating intraductal pancreatic tumors and demonstrates the utility of integrating genetic testing with conventional diagnostic modalities for an accurate diagnosis and appropriate treatment selection.\n                  <\/jats:p>","DOI":"10.1007\/s12328-025-02098-y","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T15:31:58Z","timestamp":1738769518000},"page":"376-382","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A case of pancreatic ductal adenocarcinoma growing within the pancreatic duct mimicking an intraductal tubulopapillary neoplasm"],"prefix":"10.1007","volume":"18","author":[{"given":"Ryosuke","family":"Sato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5102-7452","authenticated-orcid":false,"given":"Kazuyuki","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayu","family":"Uka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosei","family":"Takagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Nishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Fujii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Tsutsumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Horiguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoyuki","family":"Otsuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"2098_CR1","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/0016-5085(91)90226-B","volume":"100","author":"PM Pour","year":"1991","unstructured":"Pour PM, Egami H, Takiyama Y. Patterns of growth and metastases of induced pancreatic cancer in relation to the prognosis and its clinical implications. Gastroenterology. 1991;100:529\u201336.","journal-title":"Gastroenterology"},{"key":"2098_CR2","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1007\/s00292-021-00966-1","volume":"42","author":"I Esposito","year":"2021","unstructured":"Esposito I, H\u00e4berle L, Yavas A, et al. Intraductal neoplasms of the pancreas. Pathologe. 2021;42:472\u201383.","journal-title":"Pathologe"},{"key":"2098_CR3","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1016\/S0140-6736(16)30583-9","volume":"388","author":"K Uesaka","year":"2016","unstructured":"Uesaka K, Boku N, Fukutomi A, et al. Adjuvant chemotherapy of S-1 versus gemcitabine for resected pancreatic cancer: a phase 3, open-label, randomised, non-inferiority trial (JASPAC 01). 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Histopathology. 2022;81:297\u2013309.","journal-title":"Histopathology"},{"key":"2098_CR6","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.ccell.2017.07.007","volume":"32","author":"Cancer Genome Atlas Research Network","year":"2017","unstructured":"Cancer Genome Atlas Research Network. Integrated genomic characterization of pancreatic ductal adenocarcinoma. Cancer Cell. 2017;32:185\u2013203.","journal-title":"Cancer Cell"},{"key":"2098_CR7","doi-asserted-by":"publisher","first-page":"1760","DOI":"10.1038\/modpathol.2017.60","volume":"30","author":"O Basturk","year":"2017","unstructured":"Basturk O, Berger MF, Yamaguchi H, et al. Pancreatic intraductal tubulopapillary neoplasm is genetically distinct from intraductal papillary mucinous neoplasm and ductal adenocarcinoma. Mod Pathol. 2017;30:1760\u201372.","journal-title":"Mod Pathol"},{"key":"2098_CR8","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/his.13975","volume":"76","author":"ID Nagtegaal","year":"2020","unstructured":"Nagtegaal ID, Odze RD, Klimstra D, et al. The 2019 WHO classification of tumours of the digestive system. Histopathology. 2020;76:182\u20138.","journal-title":"Histopathology"},{"key":"2098_CR9","doi-asserted-by":"publisher","first-page":"15557","DOI":"10.1038\/s41598-022-19517-6","volume":"12","author":"E Khristenko","year":"2022","unstructured":"Khristenko E, Hank T, Gaida MM, et al. Imaging features of intraductal tubulopapillary neoplasm of the pancreas and its differentiation from conventional pancreatic ductal adenocarcinoma. 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