# Late Presentation of Recurrent Solid Pseudopapillary Pancreatic Neoplasm With Liver Metastases During Pregnancy

## TL;DR

A rare case of a pancreatic tumor returning 8 years after surgery and spreading to the liver during pregnancy is presented.

## Contribution

This case extends the known recurrence interval for solid pseudopapillary pancreatic neoplasms and highlights management challenges during pregnancy.

## Key findings

- The tumor recurred 8 years after initial surgery, longer than previously reported.
- Tumor growth during pregnancy may be linked to increased progesterone receptor expression.
- Long-term surveillance beyond 5 years is recommended for recurrence monitoring.

## Abstract

Our case highlights a rare instance of recurrent metastatic solid pseudopapillary epithelial neoplasms of the pancreas, emerging 8 years after radical pancreatic resection—an extended interval surpassing the reported average. Managing solid pseudopapillary epithelial neoplasm during pregnancy is uniquely challenging, given the increase in the expression of progesterone receptors during the intrapartum period, leading to tumor growth. Although surgical resection remains the primary approach, systemic chemotherapy, radiation therapy, and liver transplant are other considerations. The absence of consensus guidelines for recurrence monitoring emphasizes the need for vigilant, long-term surveillance extending beyond the conventional 5-year mark.