Pediatric Pancreatic Pseudocyst Presenting as a Solid Perigastric Mass: An Uncommon Diagnostic Pitfall

Pancreatic pseudocysts are rare in children and typically arise after episodes of pancreatitis or abdominal trauma. Their diagnosis generally relies on imaging studies, where they are expected to appear as fluid-filled collections. We describe a case of a 3-year-old girl who has no previous occurrences of pancreatitis or trauma, in whom an unexpected heterogeneous, hypoechoic perigastric mass was incidentally detected during an ultrasound examination. The lesion demonstrated a consistent, firm appearance during an 8-month follow-up period and continued to be without symptoms. Laboratory examinations, including pancreatic enzymes assay, returned normal results, and imaging studies could not determine its characteristics. A laparoscopic excision was conducted for both diagnostic and treatment reasons. Histological and immunohistochemical analysis confirmed the diagnosis of a pancreatic pseudocyst. Postoperative recovery was uneventful. This case demonstrates a rare solid appearance of a pancreatic pseudocyst in a child who does not have previous pancreatic disease, emphasizing the critical importance of histopathological examination and surgical intervention when imaging results are unclear.