Urgent Whipple resection for solid pseudopapillary tumor of the pancreas

Abstract

We report a 14-year-old boy who was urgently transferred to our institution after a blunt abdominal trauma. CT scan and repeated ultrasound examinations revealed a subhepatic mass, which slowly increased in size. Imaging features were not specific enough to permit a precise diagnosis. Because of the positive peritoneal signs and increased signs of circulatory instability, the decision was made to perform an urgent explorative laparotomy. The exploration revealed that the large haematoma-like bleeding mass was a tumor arising from the head of the pancreas, which ruptured on the surface. We performed a curative R0 Whipple resection. Histology of the resected specimen revealed a solid pseudopapillary tumor of the pancreas, an extremely rare tumor predominantly occurring in young and middle-aged women. It has a favorable prognosis if resected radically. The boy is well 30 months after the operation. To our knowledge, there are only two other descriptions of pancreatic solid pseudopapillary tumor in boys treated urgently by Whipple resection because of acute presentation after blunt abdominal trauma.