Unraveling a Rare Case of Pediatric Solid Pseudopapillary Neoplasm With a Replaced Common Hepatic Artery Arising From the Superior Mesenteric Artery.

Pancreatic solid pseudopapillary epithelial neoplasm (SPEN) is a rare pancreatic tumor with low-grade malignant potential. They often present in young women in their second and third decade of life, with only a small minority concerning children. It has a good prognosis, with a five-year survival rate of up to 97%. A common hepatic artery (CHA) arising from the superior mesenteric artery (SMA) is a rare occurrence. A 12-year-old girl, admitted with features of obstructive jaundice, was evaluated to have a heterogeneously enhancing mass lesion of size 7.5 × 7.2 cm involving the head of the pancreas on contrast-enhanced CT of the abdomen (CECT). CT angiogram showed a CHA trunk arising from the SMA and a type V hepatic arterial variation. Whipple's pancreaticoduodenectomy was done for the patient, and the postoperative period was uneventful. The subsequent histopathology report was confirmatory for SPEN, with an R0 margin of resection. SPENs of the pancreas are extremely rare, and after surgical resection, they often have an excellent long-term prognosis. Variations in hepatic artery anatomy, as in this case, need meticulous dissection to avoid inadvertent vascular insult.