SOLID PSEUDOPAPILLARY EPITHELIAL NEOPLASM (SPEN) OF THE PANCREAS

Matlhatse Phuti Maluleke [1] , Elliot Motloung [2] , Eliyah Aaron Sischy [3]

Faculty of Medicine, Sefako Makgatho Health Science University, Department of Pediatric

Surgery, Molotlegi street, Ga-Rankuwa Zone 1, 0208

Correspondence to: phuttym@gmail.com, Department of Pediatric Surgery, P. O. Box 231, MEDUNSA,

0204, Tel (+2712) 521 4921, Fax (+2712) 521 4467

Abstract

Introduction: Solid pseudopapillary epithelial neoplasms (SPENs) of the pancreas are rare neoplasms, particularly uncommon in children and males. They predominantly affect young females in their second and

third decades of life. SPENs are typically indolent in nature and often detected incidentally during physical examination or imaging performed for unrelated reasons. According to the World Health Organization (WHO), SPENs are low grade malignant neoplasms with a favourable prognosis.

Case Report: We report a case of an 8-year-old female presenting with clinical features of obstructive jaundice. CECT scan of the abdomen revealed a solid, heterogeneously enhancing mass in the pancreatic head, associated with dilatation of the intrahepatic, extrahepatic, and pancreatic ducts. The patient underwent a Whipple’s procedure without intraoperative complications. Postoperative recovery was unremarkable. Histopathological analysis demonstrated a circumscribed, encapsulated neoplasm with mixed solid and pseudopapillary areas; the solid regions contained uniform cells with capillary sized vessels. Immunohistochemistry confirmed SPEN, and an R₀ resection was achieved, with no features of malignancy.

Conclusion: This case underscores the importance of considering SPEN in young children presenting with obstructive jaundice. R₀ resection provides definitive treatment with excellent prognosis.