Pancreatic tail solid pseudopapillary neoplasm mimicking mucinous cystic neoplasm: case report and literature review

Introduction: Solid pseudopapillary neoplasms (SPNs) are rare, low-grade malignant pancreatic tumors, predominantly affecting young females, and often pose diagnostic challenges due to overlapping radiological features with other cystic pancreatic lesions. Case presentation: A 30-year-old female presented with a 2-month history of left upper abdominal pain. Contrast-enhanced computed tomography revealed a 7-cm multicystic lesion in the pancreatic tail, suggestive of a mucinous cystic neoplasm. She underwent distal pancreatectomy with splenectomy, and histopathology confirmed an SPN. The postoperative course was uneventful, with good recovery at a 1-month follow-up. Discussion: This case underscores the limitations of imaging in differentiating SPNs from other cystic pancreatic neoplasms. Despite adjuncts such as endoscopic ultrasound with fine-needle aspiration, a definitive diagnosis often relies on histopathological evaluation. Given their malignant potential, surgical resection remains the mainstay of management. Conclusion: SPNs should be considered in young females presenting with pancreatic cystic lesions. Early surgical intervention enables a definitive diagnosis and is associated with an excellent prognosis and favorable long-term outcomes.