Question: A 63-year-old man visited our hospital because of epigastric discomfort. He had no family history of pancreatic cancer, and abdominal examination was unremarkable. Serum levels of elastase 1 (1199 ng/dL; normal 100–400) and DUPAN2 (190 U/mL; normal <150) were elevated; however, serum levels of carcinoembryonic antigen, carbohydrate antigen 19-9, pancreatic polypeptide, gastrin, insulin, and vasoactive intestinal peptide were normal. Abdominal computed tomography (CT) showed a well-marginated round mass, 6 cm in diameter, in the pancreatic head, as well as a dilated caudal main pancreatic duct.