# A Unique Presentation of Solid Pseudopapillary Neoplasm of the Pancreas Requiring Pancreaticoduodenectomy Without Pancreatojejunostomy: A Case Report and Literature Review

## TL;DR

A rare case of a male with a large pancreatic tumor required a unique surgery, showing that complete removal is still recommended despite unusual features.

## Contribution

Presents a unique surgical approach for SPN in the pancreatic head without pancreaticojejunostomy.

## Key findings

- A male patient with a large, calcified SPN in the pancreatic head underwent successful surgery.
- Complete resection of SPNs is advisable even in unusual cases due to their potential for favorable outcomes.
- No preoperative markers reliably indicate aggressive behavior in SPNs.

## Abstract

Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare tumors that predominantly affect young females and are typically located in the body and tail of the pancreas. Here, we present the case of a 59-year-old male with a large, heavily calcified SPN in the pancreatic head. His surgical history includes an aborted pancreaticoduodenectomy due to vascular involvement, followed by a gastrojejunostomy. Twenty years after the initial discovery, a pancreaticoduodenectomy was performed - the first of its kind - where the pancreas was completely atrophied, and no pancreaticojejunostomy was performed. Histological examination revealed typical features of SPN. This case demonstrates that even with relatively large lesions in a male patient over an extended duration, SPNs can still exhibit favorable features, highlighting the absence of specific preoperative markers for aggressive tumors. Therefore, unless there is an absolute contraindication, complete resection of all SPNs remains advisable.