Solid and cystic pseudopapillary tumor (SCPT) is an uncommon cancer that typically affects young women. Most patients with SCPT have a favorable prognosis provided a complete resection is attained. There are anecdotal reports of the use of neoadjuvant chemotherapy or radiation therapy for patients with unresectable tumors. We report the case of a 14-year-old female with SCPT who was successfully downsized with gemcitabine before definitive surgical resection. © 2009 Elsevier Inc. All rights reserved.