Abstract
RATIONALE: Franz tumor, which has been classified as solid pseudopapillary neoplasm (SPN) of the pancreas, is a rare tumor with low malignant potential that occurs mainly in young women. Its clinical manifestations are atypical or asymptomatic, diagnosis is often incidental or detected by imaging for other reasons, and little is known about their optimal treatment. This analysis aimed to increase knowledge about the occurrence and treatment strategies of SPN. PATIENT CONCERNS: A 17-year-old female who presented for 6 weeks with asymptomatic microscopic hematuria (AMH) was admitted after an outpatient ultrasound examination revealed a pancreatic mass. DIAGNOSES: Abdominal enhanced computed tomography and magnetic resonance imaging revealed a solid pseudopapillary tumor of the pancreas, the large tumor involving the splenic artery and pressing on the left kidney. INTERVENTIONS: The patient underwent distal pancreatectomy and splenectomy, and SPN was confirmed by histopathology. OUTCOMES: She did not experience any complications and was discharged from the hospital after recovery. Postoperative reexamination and the 4-month follow-up showed that the hematuria disappeared and the tumor did not recur. LESSONS: The diagnosis of SPN is often incidental, as most patients are asymptomatic or have atypical symptoms. Most of the pathological manifestations were low-grade tumors. Surgical resection is still the standard of care. AMH caused by SPN is extremely rare, and the association may be attributed to exogenous tumor growth involving the kidney. As with getting an early diagnosis, surgery can be a challenge, but patients with SPN are associated with an excellent prognosis after surgery. Suspicion and proper investigation are essential to diagnose this entity in a timely manner.