Introduction Duodenal gangliocytic paragangliomas (GPs) are a subclass of duodenal neuroendocrine neoplasms and are exceedingly rare. They have been associated with an indolent behavior; however, they can rarely metastasize. Radical resection like a pancreaticoduodenectomy is sometimes indicated. We hereby present a case requiring major surgery and perform a literature search about this disease. Presentation of Case A 49-year-old Caucasian female, who presented with an upper gastrointestinal bleed, was found to have a hypodense mass in the second/third portion of the duodenum. A biopsy of the mass during upper endoscopy was inconclusive. A pancreaticoduodenectomy was recommended based on the high suspicion for a duodenal adenocarcinoma and was performed successfully. Her final pathology revealed a duodenal gangliocytic paraganglioma. Discussion The majority of duodenal GPs present as gastrointestinal bleeds while others less commonly present with anemia, abdominal pain, duodenal obstructive symptoms, pancreatitis, or abnormal incidental findings on axial abdominal imaging. Duodenal GPs were initially viewed as benign tumors of the duodenum; however, there have been increasing incidence reports of hematogenous and lymphatic metastasis. Appropriate treatment of duodenal GPs is still controversial and ranges from local endoscopic submucosal resection to major radical surgery. Conclusion Duodenal GPs are very rare tumors of the second portion of the duodenum presenting with upper gastrointestinal bleeding and local symptoms of surrounding organs. Local or radical resection is usually recommended to prevent bleeding and the minor risk of metastatic spread.

No abstract

No abstract

No abstract

Bumble bees are important pollinators for a great diversity of wild and cultivated plants, and in many parts of the world certain species have been found to be in decline, gone locally extinct, or even globally extinct. A large number of symbionts live on, in, or with these social bees. We give an overview of what is known about bumble bee ecto-symbionts and parasitoids. We provide information on assessment of risks posed by select bumble bee symbionts and methods for their detection, quantification, and control. In addition, we assess honey bee hive products such as pollen and wax that are used in commercial bumble bee production, and highlight key risks and knowledge gaps. Knowledge of these potential threats to native pollinators is important and they need to be managed in the context of national and international commercial trade in bumble bees to prevent pest introduction and pathogen spillover that can threaten native bees.