The patient is a female, 24 years old. Recurrent right upper abdominal pain and radiating pain in the back of the shoulder for 3 weeks, with vomiting and diarrhea, without fever and other symptoms. Physical examination: the upper abdomen was full, and a 125px-sized mass was palpated in the right upper abdomen with mild tenderness, smooth surface and tough texture. Ultrasound examination: a 7.2×5.3×162.5px oval-shaped mixed echogenic mass was seen in the pancreatic area, with moderately substantial echogenicity and a few anechoic areas inside, with clear boundaries and a complete hyperechoic envelope. No dilatation of the main pancreatic duct or biliary system was seen. Color Doppler imaging (CDFI): a richer blood flow signal was seen around the mass, and a small amount of branching and punctate blood flow signal was seen inside. CT examination: a 5.8×120px heterogeneous low-density mass with intact envelope was seen in the pancreatic head area on plain scan; the envelope was significantly enhanced on enhanced scan, and most of the mass was mildly enhanced internally, while a small portion was not enhanced. Intraoperative findings: 6×175px hard mass in the head of the pancreas with a still smooth surface and intact envelope, no significant abnormalities in the body and tail of the pancreas; the tissue around the mass was compressed and displaced to the periphery. The mass was excised completely, and the mass was dissected, and the cut surface was grayish-yellowish-grayish-red, mostly papillary in shape. Pathological examination: microscopically, the tumor cells were uniform in morphology and size, with eosinophilic or transparent cytoplasm, arranged in papillary and solid structures, with pseudo-chrysanthemum-like structures, abundant blood sinuses with hemorrhage, no obvious nuclear heterogeneity and nuclear division, and no obvious nerve or vascular invasion. Pathological diagnosis: solid-pseudopapillary tumor of the pancreas. Discussion: Pancreatic solid-pseudopapillary tumors, also known as pancreatic solid-cystic tumors, papillary-cystic tumors, solid and papillary epithelial tumors, account for 1% to 2% of all pancreatic exocrine tumors. They are more common in young women and rare in men. The tumor can be seen in any part of the pancreas with no obvious site predilection. Usually, the tumor is detected incidentally during routine physical examination or when the tumor causes abdominal discomfort and pain, or sometimes after abdominal trauma. Jaundice is rare even if the tumor is located in the head of the pancreas. There is no associated functional exocrine syndrome. The tumor tissue is usually clearly demarcated from the surrounding normal pancreatic tissue and is generally large in size (3-450 px, average 8-250 px), with very extensive necrosis, and usually only the residual tumor tissue is visible below the fibrous envelope in the peripheral part of the tumor. In this case, solidity was the main feature, and only a few necrotic liquefied areas were seen, which is rare, but the microscopic pathological changes were more typical. Ultrasound is a good means of examining solid-pseudopapillary tumors of the pancreas. This case is located in the head of the pancreas, which is better differentiated from pancreatic cancer, jugular carcinoma and carcinoma of the lower bile duct, which are most commonly found in the head of the pancreas. However, solid-pseudopapillary tumors of the pancreas tend to occur in young women, and the large size and mild clinical symptoms provide a basis for differential diagnosis.