Delayed Presentation of Metastatic Solid Pseudopapillary Epithelial Neoplasm in a Pregnant Woman: A Case Report

Solid pseudopapillary epithelial neoplasm (SPEN) is a rare, low-grade malignant pancreatic tumor usually found incidentally on imaging, most commonly in young women. Its association with women suggests that hormones may play a significant role in tumor pathogenesis. Surgical resection is the mainstay of treatment in all stages of disease, and few other treatment options have been thoroughly explored. This case demonstrates the unique therapeutic challenges involved in the management of a pregnant woman with new liver metastasis and significant disease burden following remote resection of the primary SPEN tumor. The patient was treated with chemotherapy, radiation, and hormone therapy, followed by hepatic trisegmentectomy without recurrence during surveillance. This case presents a unique therapeutic approach to a situation where no established treatment guidelines exist.