As far as I know Axkit is the only XML application server in Perl. I don't have any practical experience with it, but from AxKit.com, AxKit.orgthe traffic on the AxKit mailing list and the fact that it is written by Matt Sergeant it looks like it is well supported.
AxKit supports 2 stylesheet languages: XSLT (through interfaces to Sablotron, Xalan and libXSLT) and XPathScript, which I think was once called notXSLT, which is a more Perlish stylesheet language written by Matt.
I am not sure about the PDF and RTF output though, but you can certainly subscribe to the AxKit mailing list which should be at http://axkit.org/mailinglist.xml and ask for more info.