A 64-year-old man presented to pain in the left upper quadrant and weight loss. Findings on magnetic resonance imaging (MRI) of the abdomen included the filling of mass in whole pancreatic ducts with marked dilatation (Figure 1A,B, within yellow dots). Total pancreatectomy was performed and whole pancreas replaced by intraductal mass like lesion (Figure 1C). Mural nodules filled with the whole pancreas. Pathologic result revealed intraductal tubulopapillary neoplasm (ITPN) with invasive carcinoma.