Intraductal tubulopapillary neoplasm of the pancreas with somatic BRAF mutation

Takahiro Urata, Yoshiki Naito, Michiko Nagamine, Yoshihiro Izumi, Ginga Tonaki, Hajime Iwasaki, Akiko Sasaki, Akira Yamasaki, Nobuhiro Minami, Rituko Yoshioka, Hideki Kitada, Yoshi Takekuma, Hiroshi Yokomizo, Seiji Fukuda, Hiroshi Yamaguchi, Yuko Kuboki, Toru Furukawa, Michio Hifumi

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13 Citations (Scopus)


Intraductal tubulopapillary neoplasm (ITPN) is a rare pancreatic tumor belonging to a newly recognized entity that is coined in the 2010 WHO classification. We present a case of ITPN-associated microinvasive adenocarcinoma that developed in an asymptomatic 78-year-old patient. The tumor demonstrated all the clinical, radiological, and pathological characteristics of ITPN, but it differs from other reported cases of ITPN in molecular analysis, which revealed a somatic mutation in BRAF (c.1799T>A; p.V600E) but no mutation in PIK3CA. Post-operative recurrence was discovered 34 months after tumor resection with negative margins and a 6-month course of adjuvant chemotherapy. To the best of our knowledge, this is the first case of ITPN with BRAF mutation. This case suggests that an activation of RAS-mitogen-activated protein kinase signaling pathway may play a role in development of some of ITPNs. A possible mechanism of tumor recurrence in ITPN is also discussed. Further case series with molecular study are awaited to delineate the clinicopathological and molecular characteristics of ITPN.

Original languageEnglish
Pages (from-to)413-420
Number of pages8
JournalClinical Journal of Gastroenterology
Issue number6
Publication statusPublished - 2012 Dec
Externally publishedYes


  • BRAF
  • Intraductal tubulopapillary neoplasm
  • Microinvasion
  • Pancreas
  • Recurrence

ASJC Scopus subject areas

  • Gastroenterology


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