While the gastric and intestinal subtypes of IPMNs are easier to distinguish from ACCs morphologically due to their mucinous epithelium, caution should be exercised when differentiating a pancreatobiliary-type IPMN from ACC since they often display high-grade dysplasia and less cytoplasmic mucin [5, 6]. Here, MUC5AC is linked to adrenal cortex carcinoma.