A case of an unusual pancreatic tumor with a characteristic papillary-cystic microscopic morphology is presented. Review of four previously reported similar cases suggests a distinct clinical picture of a large abdominal mass occurring in a young person which apparently, after resection, does not rapidly recur. The histopathology of this tumor consists of papillary and cystic patterns, regular homogeneous cells with a few mitoses, glassy eosinophilic cytoplasm, and mucin and PAS positivity. Ultrastructural detail, including eccentric nucleoli, numerous mitochondria, sparse endoplasmic reticulum, and little evidence of secretory activity, suggests a duct cell origin for this rare tumor.