Solid Pseudopapillary Neoplasm of the Pancreas Misdiagnosed as Ovarian Torsion in the Second Trimester of Pregnancy

Solid pseudopapillary neoplasm (SPN) of the pancreas is a low-grade malignant tumor affecting young women. Presentation during pregnancy is extremely rare and poses unique diagnostic and management challenges. We present a case of a 23-year-old primigravida at 25 weeks of gestation with recurrent epigastric pain and vomiting. Initial imaging suggested an adnexal mass, raising concerns about ovarian torsion. However, further assessment with MRI revealed a large heterogeneous mass anterior to the left kidney and near the pancreas. Diagnostic laparotomy confirmed a 15 cm mesenteric mass that was completely resected. Histopathological and immunohistochemical evaluations confirmed that the SPN originated in the pancreas. The patient recovered uneventfully and gave birth to a healthy, full-term infant. This case highlights the importance of SPN in the differential diagnosis of abdominal masses during pregnancy and illustrates the safety of second-trimester surgical management.