An 18-year-old woman came to the emergency room because of epigastric pain of one week of evolution. She was at 28.5 weeks of gestation of her first pregnancy. On physical examination, pain on deep palpation was found in the epigastrium. After an initial workup by ultrasound, an MRI was performed that showed a tumor of the pancreatic body of 8×7.2×9.1cm with well-defined borders and a hypointense capsule on T2. The tumor was heterogeneous with a hemorrhagic component and solid papillary-like projections and displaced the liver and stomach. A single intrauterine fetus in a transverse lie was seen (Fig. 1). The carcinoembryonic antigen (CEA) level was 0.68ng/mL (normal value 0–5ng/mL) and CA 19-9 was 10.56U/mL (normal value<37U/mL). Because of clinical suspicion of a solid pseudopapillary tumor of the pancreas (SPTP), we decided to provide symptom control and take the pregnancy to term for subsequent tumor resection.
Clinical experience with SPTPs diagnosed during pregnancy is scarce because of the rarity of this presentation. Due to its low malignant potential, in the majority of cases, close surveillance of tumor rupture or growth is usually carried out, reserving resection for the postpartum period.
