Pancreatoblastoma in a 2.5-Year-Old Child: Imaging and Histopathologic Correlation in a Diagnostic Challenge

Background: Pancreatoblastoma is a rare malignant pancreatic tumor and the most common pancreatic malignancy in children. Its diagnosis is often difficult due to nonspecific presentation and overlap with other pediatric abdominal tumors. Case Presentation: A 2.5-year-old female presented with abdominal distension and intermittent pain. Examination revealed a large abdominal mass. Ultrasonography showed a heterogeneous solid-cystic lesion, and contrast-enhanced CT demonstrated a well-defined mass arising from the pancreatic body and tail with an enhancing solid component and no calcifications, displacing adjacent structures. PET-CT showed no metastases. Initial biopsy suggested neuroblastoma, and chemotherapy was started. However, following surgical excision, histopathological and immunohistochemical findings confirmed pancreatoblastoma. Conclusion: Pancreatoblastoma should be considered in young children presenting with large abdominal masses, particularly when imaging suggests pancreatic origin. This case highlights the risk of misdiagnosis and the importance of correlating imaging with histopathology for accurate diagnosis and management.