Pancreatic solid pseudopapillary neoplasm: Case report of an uncommon tumor and a brief review of the literature

Solid pseudopapillary neoplasm (SPN), also called Frantz tumor, is a low-grade pancreatic neoplasm with low malignant potential and is mostly found in young women. It may be a diagnostic challenge because it is rare and often presents with nonspecific symptoms. A 22-year-old woman reported progressive pain in the left upper quadrant of her abdomen, early satiety, and slight weight loss in the last three weeks. The physical examination revealed a tender, palpable mass. Abdominal CT and MRI showed that a big, 8.5 cm, well-encapsulated, heterogeneous solid and cystic mass was present in the tail of the pancreas, which is typical of an SPN with hemorrhagic and necrotic components. This patient had a splenectomy and a distal pancreatectomy. The diagnosis was confirmed using histopathology, which revealed a neoplasm with solid and pseudopapillary structures. Immunohistochemistry was positive for β-catenin and CD10. The surgical margins were negative, and the Ki-67 index was low (2%). The patient managed to recover without issues and is still in the disease-free period 16 months after surgery. The case is a typical example of SPN presentation, emphasizing the necessity of considering typical clinical and radiological features to diagnose it properly and perform a timely surgery. Most cases can be treated by performing an entire surgical resection, which provides a good long-term prognosis.