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Fig. 18. —Intraductal pancreatic ductal adenocarcinoma simulates main duct intraductal papillary mucinous neoplasm in this 71-year-old man presenting with steatorrhea. Endoscopic retrograde pancreatogram shows nodular filling defect on initial injection of contrast material. On subsequent injection, this filling defect did not move. There is ductal dilatation upstream. At surgery, this was ductal pancreatic carcinoma with primarily intraductal growth.

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