Frantz-Gruber tumor with atypical presentation as a pancreatic pseudocyst following abdominal trauma: a case report

Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor with low malignant potential, mainly affecting young women.

A 15-year-old female with prior blunt abdominal trauma presented with epigastric pain and nausea. Laboratory tests showed elevated amylase levels. CT imaging revealed a calcified cystic lesion in the pancreatic head, initially diagnosed as a pancreatic pseudocyst. Due to persistent symptoms and diagnostic uncertainty, surgical exploration was performed. Intraoperatively, a solid-cystic pancreatic head mass adherent to the hepatoduodenal ligament was identified. Frozen-section analysis suggested mucinous neoplasia, leading to pancreatoduodenectomy (Whipple procedure). Final histopathology and immunohistochemistry confirmed SPN with a low proliferative index (Ki-67 < 1%) and no lymph node involvement.

SPN can mimic pancreatic pseudocysts, particularly following abdominal trauma, leading to diagnostic challenges. Imaging features, such as calcifications and mixed solid-cystic components, may aid in diagnosis.

SPN should be considered in the differential diagnosis of pancreatic cystic lesions in young patients, especially when clinical and imaging findings are atypical for pseudocysts.