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

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.

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.

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.

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.