not-yet-known not-yet-known not-yet-known unknown Key clinical message This case reports a rare co-occurrence of pancreatic intraductal papillary mucinous neoplasm with invasive carcinoma and ampullary neuroendocrine tumor. Laparoscopic pancreaticoduodenectomy was done. No recurrence/metastasis in 9-month follow-up, though both tumors had lymph node metastasis, warranting attention of timely biopsy.