Pancreatic malignancies account for 3% of all cancer diagnoses in the UK and prognosis is poor with overall 1-year survival rates at 20% and 5-year survival rates at 5%. The majority of these cancers (75%–95%) arise from the exocrine part of the gland and are almost all invasive ductal adenocarcinomas. One per cent of all pancreatic tumours are endocrine tumours. There is limited data regarding the management of such rare neoplasms of the pancreas and some evidence suggests that prognoses and risk factors may be different. Therefore, it is important to report experience of this type of malignancy in order to build a knowledge base to guide the practice of future clinicians. The authors report a case of an intraductal tubulopapillary neoplasm of the pancreas. This is very unusual form of intraductal pancreatic tumour, which is now thought to occupy a distinct histological subcategory and has arisen within a previously irradiated field.