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SPNing our wheels-Pancreatic solid pseudopapillary neoplasm as an extraluminal etiology of persistent duodenal

Kanak V Kennedy1,2, Jibraan A Fawad1, Y Dana Neugut1

  • 1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics Children's Hospital of Philadelphia Philadelphia Pennsylvania USA.

JPGN Reports
|May 19, 2025
PubMed

Insights

Pediatric duodenal ulcers causing upper GI bleeding can stem from rare pancreatic tumors. This case highlights solid pseudopapillary neoplasms (SPNs) as an unusual extrinsic cause, emphasizing the need for suspicion with recurrent ulceration.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Oncology
  • Gastrointestinal Pathology

Background:

  • Pediatric upper gastrointestinal (GI) bleeding from duodenal ulceration is a critical condition.
  • A wide range of diagnoses can cause these ulcers.
  • Pancreatic tumors are an uncommon cause of duodenal pathology.

Purpose of the Study:

  • To report a rare case of pediatric duodenal ulceration caused by a pancreatic head solid pseudopapillary neoplasm (SPN).
  • To emphasize SPNs as an extrinsic cause of duodenal ulceration.
  • To increase awareness of extraluminal etiologies for recurrent duodenal ulcers.

Main Methods:

  • Case report presentation.
  • Review of clinical presentation, diagnostic workup, and management.
  • Literature review on pancreatic SPNs and duodenal pathology.

Main Results:

  • A pediatric patient presented with recurrent upper GI bleeding due to duodenal ulceration.
  • The ulceration was found to be caused by a solid pseudopapillary neoplasm (SPN) of the pancreatic head.
  • The SPN was identified as an extrinsic mass compressing the duodenum.

Conclusions:

  • Pancreatic SPNs are a rare but significant extrinsic cause of duodenal ulceration in children.
  • Recurrent or progressive duodenal ulceration without obvious internal causes warrants investigation for extraluminal masses.
  • Early recognition and diagnosis of pancreatic SPNs are crucial for effective management in pediatric patients.

Keywords:
duodenal ulcerpancreassolid pseudopapillary massupper GI bleeding

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