Solid pseudopapillary neoplasms (SPNs) of the pancreas (also known as Franz tumours) are rare, representing 1%–2% of pancreatic tumours. They are of exocrine gland origin and are more prevalent in women under the age of 30. They are classified as low-grade malignancies and are usually treated with surgery.We present the case of a young woman who was found to have a pancreatic head lesion obstructing the superior mesenteric vein and encasing the superior mesenteric artery. Diagnosis of SPN was confirmed on histology. Initially deemed unresectable due to vascular encasement, the patient received neoadjuvant chemotherapy to downstage the tumour. This was unsuccessful. Given the patient’s young age and lack of other options, surgery was performed. Instead of vascular resection, the tumour was split and peeled off the superior mesenteric artery giving an R1 resection. The patient has achieved long-term recurrence free survival at 10 years.

Extracorporeal shock wave lithotripsy (ESWL) is a standard treatment for nephrolithiasis. It is widely employed due to its relative safety profile when compared with other treatment options. Recognised complications include localised pain at site, steinstrasse, perinephric haematoma and ureteric obstruction. This report presents a rare non-documented complication of ESWL, pseudoaneurysm of the arc of Buhler, a branch artery of the superior mesenteric artery.