Solid pseudopapillary neoplasm of the pancreas with elevated β-HCG levels: A case report

Rationale: Solid pseudopapillary neoplasm of the pancreas, first classified as a malignant epithelial tumor of the pancreas in 2019, is rare and usually occurs in young women, with a high incidence at approximately 30 years of age. Herein, we present a case of solid pseudopapillary neoplasm of the pancreas with elevated β-human chorionic gonadotropin (HCG) levels, which, to our knowledge, has not been reported in the literature. Patient concerns: A 35-year-old woman of childbearing age presented with a chief complaint of vaginal bleeding and was admitted to our hospital. Her β-HCG level was elevated; however, a complete endometrial biopsy and related imaging examinations revealed no evidence of pregnancy or trophoblastic neoplasm. Computed tomography revealed a lump of abnormal signals in the head of the pancreas, which was suspected to be a solid pseudopapilloma. Diagnoses: Hence, surgery was performed, and the postoperative pathological diagnosis of a solid pseudopapillary neoplasm of the pancreas was confirmed. Interventions and outcomes: The tumor was completely removed by surgery. Notably, the patient’s β-HCG level gradually decreased after removal of the pancreatic mass and returned to normal levels after 1 month. Lessons: We present a case of solid pseudopapillary neoplasm of the pancreas that was diagnosed using hematoxylin and eosin staining and immunohistochemistry. In our case, the solid pseudopapillary neoplasm partially expressed β-HCG. Further studies are needed to confirm whether β-HCG promotes the occurrence and development of solid pancreatic pseudopapillary neoplasms.