Diagnosis of Solid Pseudo-Papillary Neoplasm of the Pancreas by Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology: Case Report and Brief Literature Review

Pancreatic solid pseudopapillary neoplasm (SPN), often called Frantz tumor, is a rare, low-grade malignant tumor with an excellent prognosis after surgical removal. We report the case of a 32-year-old woman who presented to her primary care physician with intermittent epigastric discomfort and early satiety for several months. CT of the abdomen with contrast revealed a 6.5 cm mass in the body and tail of the pancreas with a mixed solid and cystic appearance and a thin peripheral capsule. MRI demonstrated areas of hemorrhage and confirmed a fibrous pseudo-capsule. Immunocytochemistry (IHC) demonstrated characteristic pseudopapillary architecture, and molecular analysis confirmed a CTNNB1 mutation encoding beta-catenin, consistent with SPN of the pancreas. The patient underwent distal pancreatectomy with splenectomy, 
SPN can be diagnostically challenging due to its vague clinical presentation and overlapping features with other solid and cystic tumors of pancreatic origin. This case highlights the importance of timely recognition and multidisciplinary surgical workup and management to achieve optimal care and a favorable prognosis.