Background : Solid pseudopapillary tumor (SPT) of the pancreas is a tumor of low malignant potential, accounting for 1-3% of exocrine tumors. Published data is limited, and these tumors are especially rare in the pediatric age group. SPTs located in the pancreatic head have traditionally been treated with a Whipple procedure. This has been criticized to be too radical for what is generally regarded as a benign condition. Duodenum-preserving pancreatic head resection (DPPHR) emerged as a treatment option for chronic pancreatitis, but its use has been expanded to include benign to low grade malignant neoplasms of the pancreatic head, including SPTs.

Methods : We present two cases of DPPHR in pediatric patients with SPT done in PGH. The presentation, intraoperative findings, and post-operative status and course are discussed.

Results : Case 1 was a 13-year-old female with a 3 month history of an abdominal mass. Imaging revealed an 8x8x7 cm well-defined, complex mass at the region of the pancreatic groove. Case 2 was a 15-year-old female with a 6 month history of an abdominal mass, with a 14x12x12 cm well-defined pancreatic head mass on imaging. DPPHR was performed successfully in both cases and both were discharged well with no post-operative complications.

Conclusions : Because of the high survival rates of SPT, DPPHR may be presented as a less radical procedure for patients with SPT of the pancreatic head, while improving their quality of life due to less metabolic and endocrine side effects as compared to the classic Whipple procedure.