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World J Gastrointest Surg. Oct 27, 2026; 18(10): 123199
Published online Oct 27, 2026. doi: 10.4240/wjgs.123199
Aggressive pediatric solid pseudopapillary neoplasms of the pancreas presented as acute abdomen: A case report and review of literature
Xiao-Yang Zhou, Tong Chen, Juan Liang, Jin-Quan Yue, Li-li Wu, Hui-Meng Li, Zhi-Heng Liu, Cheng-Jiang Peng, Gong-Wu Liu
Xiao-Yang Zhou, Jin-Quan Yue, Zhi-Heng Liu, Cheng-Jiang Peng, Gong-Wu Liu, Department of Hepatobiliary Surgery, The First People’s Hospital of Honghe State, Gejiu 661199, Yunnan Province, China
Tong Chen, Research Center for Clinical Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
Juan Liang, Department of Pathology, The First People’s Hospital of Honghe State, Gejiu 661199, Yunnan Province, China
Li-li Wu, Department of Gastrointestinal Surgery, The First People’s Hospital of Honghe State, Gejiu 661199, Yunnan Province, China
Hui-Meng Li, Department of Thyroid and Breast Surgery, The First People’s Hospital of Honghe State, Gejiu 661199, Yunnan Province, China
Co-first authors: Xiao-Yang Zhou and Tong Chen.
Author contributions: Zhou XY and Chen T contributed to manuscript writing and editing; Liang J contributed to the histopathological and immunohistochemical analyses; Liu ZH, Peng CJ, and Yue JQ contributed to the clinical data collection and follow-up; Zhou XY, Wu LL, Li HM, and Liu GW contributed to conceptualization and supervision; and all authors have read and approved the final manuscript.
AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.
Supported by Yunnan Provincial Department of Science and Technology - Kunming Medical University Special Projects, No. 202301AY070001-206; The Applied Basic Research Projects of Yunnan Province, No. 202501AT070042
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Gong-Wu Liu, Associate Chief Physician, Deputy Director, Department of Hepatobiliary Surgery, The First People’s Hospital of Honghe State, No. 1 Xiyuan Road, Datun Subdistrict, Gejiu 661199, Yunnan Province, China.
lgw20262013@163.com
Received: May 12, 2026
Revised: July 22, 2026
Accepted: August 20, 2026
Published online: October 27, 2026
Processing time: 153 Days and 6.9 Hours
BACKGROUND
Solid pseudopapillary neoplasm of the pancreas (SPN) is a rare, low-grade malignant tumor. In children, it rarely exhibits aggressive malignant features or presents as a rapidly progressive acute abdomen.
CASE SUMMARY
A 16-year-old female patient was admitted with abdominal pain accompanied by nausea and vomiting for three hours. An abdominal ultrasound scan, Contrast-enhanced abdominal magnetic resonance imaging, and computed tomography identified a space-occupying lesion in the pancreatic tail, accompanied by multiple hepatic metastases. Importantly, the lesion showed significant intratumoral hemorrhage and necrosis. On the second day after admission, the abdominal pain and physical signs worsened, accompanied by high fever and tachycardia, suggesting further exacerbation of spontaneous hemorrhage and necrosis within the tumor. Emergency laparoscopic distal pancreatectomy with biopsy of a liver lesion was performed. Postoperative pathological examination confirmed the diagnosis of SPN with local invasion and liver metastases. The patient had an uneventful postoperative recovery. At the 17-month follow-up, no tumor recurrence was observed, and the liver metastases remained stable.
CONCLUSION
This case is remarkable for its rare aggressive biological behavior, manifesting as a rapidly progressive acute abdomen.
Core Tip: We present a case of solid pseudopapillary neoplasm of the pancreas (SPN) in a child with rare aggressive features, including local pancreatic invasion and multiple liver metastases. The patient presented with acute abdominal manifestations, characterized by progressively worsening abdominal pain and rapidly developing high fever. In addition, we review the literature on the clinical presentation, aggressive malignant features, and treatment of SPN.
