ArticleFrontiers in oncology2026
Case Report: Metachronous oncocytic and colloid carcinoma arising from pancreatic intraductal neoplasms over four decades.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Intraductal papillary mucinous neoplasms (IPMN) are precursors of pancreatic ductal adenocarcinoma (PDAC) and may progress to distinct invasive phenotypes depending on epithelial subtypes. Tubular carcinoma, often arising from pancreatobiliary epithelium, is clinically aggressive and resembles PDAC, whereas colloid carcinoma, typically derived from intestinal epithelium, has a more indolent course. Intraductal oncocytic papillary neoplasms (IOPN), historically considered a subtype of IPMN, are now recognized as a distinct entity characterized by abundant eosinophilic cytoplasm, complex papillary architecture, and unique molecular alterations. Although the heterogeneity of intraductal pancreatic neoplasms (i.e., IPMN, IOPN, ITPN) is recognized, the mechanisms and temporal dynamics underlying their malignant progression remain poorly understood. We report the case of a female patient in her 80s with a pancreatic body cyst first identified in her 40s. After decades of radiologic stability, she underwent a middle pancreatectomy in 2017, which showed a 1.5 cm oncocytic carcinoma (pT1N0) arising from an IOPN. After surgical resection, she remained disease-free for eight years. In 2025, she developed a new pancreatic head cyst and underwent pancreaticoduodenectomy, which revealed a colloid carcinoma (pT3N0) arising from an intestinal-type IPMN. Molecular profiling of the 2025 specimen demonstrated shared driver alterations in the intestinal-type IPMN and associated colloid carcinoma (
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