Mucinous ductal ectasia is associated with a very characteristic clinical picture. In this tumor the lining of the pancreatic duct becomes malignant and the cancer cells produce large amounts of thick mucous. The mucous often blocks the pancreatic duct causing recurrent attacks of pancreatitis. This tumor occurs predominantly in the older men with a median age of 66 years. A history of heavy smoking is frequent. The treatment of choice is removal of the tumor at surgery. These tumors are very slow growing and therefore conservative treatment of these tumors without surgery has been advocated. A risk of doing this is possible future development of invasive pancreatic cancer, and we therefore would recommend surgery if the patient is otherwise in excellent health.