An unusual presentation of a solid pseudopapillary pancreatic tumor
An otherwise healthy 14-year-old girl was referred to the Department of surgery Uppsala University Hospital from another hospital where she underwent a trauma-CT after receiving an elbow to the abdomen during a basketball game. The CT displayed no signs of traumatic injury, but revealed a 6.5 × 4.5 × 5.0 cm large tumor in the pancreatic head (Figs and ) which displaced the portal vein, vena cava and hepatic artery. Further investigation revealed that the patient had felt tired and had lost some weight during the past 6 months. Contrast-enhanced ultrasound with Doppler indicated a tumor with both solid and cystic structures, but no signs of vascular encapsulation. The investigation was complemented with positron emission tomography, hormone screening and an ultrasound of the heart. On the contrast-enhanced ultrasound the tumor appeared resectable; therefore no endoscopic ultrasound or biopsies were taken.\nThe patient underwent surgery, pylorus-preserving pancreaticoduodenectomy, and recovered well post-operatively and was discharged after 9 days. In the post-operative check-up 4 weeks after discharge, the patient was still doing well and histopathologic examination revealed an R0-resected solid pseudopapillary pancreatic tumor (SPPT).\nThe follow-ups were conducted at the referring hospital and MRI of the pancreas has been performed twice: 4 years after the operation, there were no signs of recurrence.