Solid pseudopapillary neoplasm of the pancreas: A case report

RATIONALE: Solid pseudopapillary neoplasm (SPN) of the pancreas, first described in 1959, is a rare low-grade tumor associated with a good prognosis. PATIENT CONCERNS: We report the case of a 28-year-old man without significant preexisting disease who underwent abdominal computed tomography for suspected diverticulitis. Subsequently, an incidental finding revealed a pancreas with a homogeneous structure and a hypodense lesion measuring 22 × 19 mm located in the cranial aspect of the pancreatic body, which was visible in the arterial phase. DIAGNOSES, INTERVENTIONS, AND OUTCOME: It was suspected to be a tumor closely adjacent to a. lienalis, and infiltration of the artery could not be ruled out. Cytological analysis revealed a well-differentiated neuroendocrine tumor. The patient was then admitted to our hospital for surgery. Subsequently, the diagnosis of SPN of the pancreas was confirmed. LESSONS: Differentiating neoplasms from other pancreatic tumors such as neuroendocrine tumors using cytological or biopsy samples can be challenging. Although a laparotomic approach is usually preferred for these tumors, laparoscopic pancreatectomy is associated with reduced intraoperative blood loss, and shorter operative and hospitalization times. Patients with SPNs usually have a good prognosis after surgery, even in cases of local invasion or multiple metastases. More than 95% of patients with solid pancreatic pseudopapillary neoplasms and no infiltration of the surrounding tissues were treated with complete surgical excision.