INTRODUCTION
SPNs are rare tumors comprising only 1 to 3% of all pancreatic tumors [1]. There is a clear female preponderance (95.2% in a 29 case series) of young age (from 24 to 39 years) [2]. SPNs were first described by Frantz in 1959 as pancreatic papillary cystic tumors [3] but the name SPN was finally defined in 2010 by WHO [4]. Usually it is a slowly growing tumor [2] incidentally found in imaging exams, not associated with major symptoms [5], although it can be detected as result of persistent unexplained upper abdominal pain [6]. Despite its gradual growth, SPN has the potential to expand significantly and generate compressive symptoms that manifest as jaundice or a palpable abdominal mass [6]. SPN do not present preferably in any specific part of the pancreas and size do not correlate with malignancy index [2]. Tumors located in the distal pancreas are more commonly larger [7]. SPNs are solitary [8] in most cases and encapsulated [2, 9].
Gold standard treatment is surgical resection by enucleation, distal pancreatectomy or pancreaticoduodenectomy [9] and definite diagnosis is obtained by histological evaluation of the specimen [10]. Solid sheets of tumor cells along with areas showing cells oriented around fibrovascular cores and periodic acid Schiff positive hyaline globules are typical histological findings [2, 11].
The majority of SPNs runs a benign course with an excellent prognosis [12] but large series documented cases of malignancy based on recurrence or metastasis in up to 22.8% cases [13, 14]. Due to its rarity, its diagnosis can be difficult and should be considered in the differential diagnosis of any solid or partly cystic pancreatic neoplasm, especially in women under 35 years of age [2].
The authors present a case of a 52 years old patient with complaints of recurrent upper abdominal pain that was diagnosed with SPN of the uncinated pancreatic process.