Solid papillary epithelial neoplasm (SPEN) is a rare low grade pancreatic tumor, also known as a solid-cystic, papillary-cystic, solid pseudopapillary tumor and Frantz’s tumor. It is a rare
pancreatic malignancy (making up 1%–2% of all exocrine pancreatic tumors) . The incidence is higher in women (M:F = 1:9) and it affects young people, with a peak incidence in the second and
third decades . But, they may occur in patients of both sexes, all races, at any age and in any part of the pancreas . Although these tumors may be very large, they rarely cause symptoms. The
occurrence of eosinophilia and / or polyarthralgia  is reported due to an intravascular release of lipase. Progesterone receptors are seen in more than 90% of the tumors, leading to growth during
pregnancy . The commonly seen degenerative changes and hemorrhage were thought to occur because of the disruption of the delicate vascular network [3, 4]. On ultrasonography, they are found to be
large, well-marginated masses, and may show solid, mixed solid and cystic, or mainly cystic components. Hemorrhage is indicated by echogenic areas. Papillary projections may be evident. The tumor
appears heterogeneous with a thick enhancing capsule on CT. Peripheral calcification is seen in up to one-third of the tumors . Detection of hemorrhage is important in differentiating SPEN from
other cystic lesions of the pancreas. An MR scan is more reliable than a CT scan in demonstrating intra-tumoral hemorrhage. Fluid debris levels may be seen. The MR technique is also useful in
showing the fibrous capsule, which is seen to be hypointense on both T1- and T2-weighted images. Metastasis (15%)  of SPEN occurs to the omentum, lymph nodes and the liver. It is important to
recognize SPEN, since these tumors have a low-grade malignant potential in contrast to adenocarcinoma, and radical excision of these tumors can be safely performed with low morbidity / mortality and
with an excellent prognosis. The differential diagnosis of SPEN includes the possibility of microcystic adenoma (older age, tiny thin-walled multiple cysts), mucinous cystic neoplasm (thin-walled and
multicystic, but the cysts are smaller and often no more than 2 cm in size), non-functioning islet cell tumor (older age, no female preponderance), pancreatic adenocarcinoma (calcification and cystic
degeneration uncommon, older age), calcified hemorrhagic pseudocyst (in the onset of pancreatitis) and pancreatoblastoma (childhood tumor, no female preponderance, more aggressive) . In
conclusion, the presence of a large well-encapsulated pancreatic mass that demonstrates calcification and regions of hemorrhagic degeneration in this young female is virtually diagnostic of SPEN.
These tumors are indolent, and metastases are often amenable to resection, thus there is a need for better prognosis and an accurate preoperative imaging diagnosis.