Frantz Tumor: Splenopancreatectomy Technical Aspects

Abstract

Background:

Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor with low malignant potential, predominantly affecting young women. Early diagnosis and complete surgical excision are associated with excellent outcomes.

Case Presentation:

A 17-year-old female presented with epigastric pain and postprandial vomiting. Contrast-enhanced CT revealed a well-circumscribed solid-cystic mass in the pancreatic body–tail. Endoscopic ultrasound with core needle biopsy confirmed SPN. The patient underwent open distal splenopancreatectomy, including systematic coloepiploic division, extended Kocher maneuver, controlled dissection of the superior mesenteric vein, and mechanical transection of the pancreatic neck with reinforced stapled closure. The procedure was completed en bloc without intraoperative complications. Postoperative recovery was uneventful. Final histopathology is pending.

Discussion:

SPN typically demonstrates favorable biological behavior, and complete resection is curative in most cases. This case underscores key technical aspects of distal pancreatectomy, such as early vascular control, careful mobilization of the splenic hilum, and reinforcement of the pancreatic stump to reduce the risk of postoperative pancreatic fistula.

Conclusion:

Distal splenopancreatectomy remains the standard surgical approach for SPN located in the pancreatic body and tail. Meticulous operative technique and adherence to oncologic principles are essential to ensure optimal outcomes in these patients.