Acute post-traumatic presentation of a solid pseudo papillary tumor of pancreas: A case report

Objective: To report a case of pancreatic pseudo papillary solid cystic tumor, known as Frantz tumor, which was discovered after a blunt abdominal trauma and to carry out a review of literature.

Case report: The patient was a 14-years old girl who came to the emergency room after blunt abdominal trauma with an intense abdominal pain. She underwent emergent laparotomy because of the positive peritoneal signs and circulatory instability. The exploration revealed a large retroperitoneal mass. Therefore, an incisional biopsy was done and the patient was referred to our center. CT-Scan was performed and revealed a large cystic mass (about 14×10cm) in left side of upper abdomen, which was located posterior to the stomach. Laparatomy revealed a very large pancreatic tumor with extension to spleen, stomach and transverse colon. A distal pancreatectomy, sleeve gastrectomy, segmental resection of large bowel and splenectomy was performed. The pathologic report was a pseudo papillary solid and cystic tumor of pancreas. Clinical evaluation has been satisfactory without recurrence after 12 months of follow up.

Conclusion: Frantz tumor has benign behavior and treatment of choice consists of surgical resection. Pseudo papillary tumor may spread outside the pancreas, particularly in peritoneal cavity. Met static spread may be promoted by trauma, including tumor biopsies which should never be performed. The outcome after surgical resection is excellent with 90% survival in the long term. Recurrence has been described in approximately 10% of the patients.