Solid Pseudopapillary Neoplasm of the Pancreatic Head With Atypical Presentation in a Young Woman: A Case Report

Solid pseudopapillary neoplasm of the pancreas is a rare low-grade malignant tumor that predominantly affects young women and often presents with nonspecific or absent symptoms, which may delay diagnosis. We report the case of a 22-year-old female patient with no relevant medical history who was referred after the incidental finding of a pancreatic mass on imaging studies. Initially asymptomatic, the lesion progressed during follow-up to a painful and palpable abdominal mass. Computed tomography and endoscopic ultrasound revealed an 8-cm heterogeneous lesion located in the head of the pancreas. Given its size, location, and progressive growth, the patient underwent surgical resection, including proximal subtotal pancreatectomy with total duodenectomy, partial antrectomy, and pancreatoduodenectomy. Intraoperative findings revealed a 15 × 12 cm encapsulated tumor with reactive lymphadenopathy. Histopathological examination confirmed a grade G1 solid pseudopapillary neoplasm staged as pT4 pN0 pMx. Postoperatively, the patient developed exocrine pancreatic insufficiency requiring enzyme replacement therapy and remains under regular oncological follow-up without evidence of recurrence. This case highlights the progressive growth of an initially asymptomatic lesion and underscores the importance of early recognition and surgical management. The atypical location in the pancreatic head further emphasizes the need to consider this diagnosis even in unusual anatomical presentations.