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Parithivel, Vellore S.; Niazi, Masooma; Malhotra, Ajai K.; Swaminathan, Krishnaswamy; Kaul, Ashutosh; Shah, Ajay

doi:10.1023/a:1005401718763

Cited by 25 publications

(7 citation statements)

References 5 publications

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“…Six of these eight tumors were located in the pancreatic head, whereas the remaining two originated from the body of the pancreas. Although the available radiologic images were limited in the previously reported cases of pancreas paraganglioma (3-5), the imaging findings were generally characterized as a well-defined mass with frequent areas of hypoechogenicity on US, a well-marginated, hypervascular tumor with cystic areas of low-attenuation on contrast-enhanced CT, and tumor displacement of the main pancreatic duct on ERCP. Although the present case is characterized by similar findings, it is unique because the dynamic CT demonstrated robust enhancement of the mass that was comparable to that of the greater abdominal vessels, prominent intratumoral vessels and early contrast filling of the main portal vein and draining veins from the mass during the arterial phase.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, only eight cases of pancreas paraganglioma have been reported (3-5). The mean age of these eight patients was 67 years (range: 42 to 85 years) with a male to female ratio of 1/7.…”

Section: Discussionmentioning

confidence: 99%

“…They have been previously characterized on radiologic images as being well-marginated, hypervascular masses with cystic areas (3-5). However, the reported CT features were those of only single equilibrium phase CT, and this modality can't show the hypervascularity of paragangliomas.…”

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confidence: 99%

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A Case of Primary Paraganglioma that Arose in the Pancreas: the Color Doppler Ultrasonography and Dynamic CT Features

et al. 2008

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Paragangliomas rarely originate from the pancreas and they are characterized on imaging studies as well-marginated, hypervascular masses with cystic areas. We herein report on a case report of pancreatic paraganglioma in a 57-year-old woman, which was confirmed on pathology. Color Doppler ultrasonography and dynamic CT demonstrated a well-demarcated, extremely hypervascular mass with prominent intratumoral vessels and early contrast filling of the draining veins from the mass. Endoscopic retrograde cholangiopancreatography showed that the main pancreatic duct was displaced and mildly dilated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Case of Primary Paraganglioma that Arose in the Pancreas: the Color Doppler Ultrasonography and Dynamic CT Features

et al. 2008

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“… 6 , 7 , 9 , 12 , 14 , 16 – 19 , 22 Two pancreatic paraganglioma patients died, 1 of whom was a patient with malignant pancreatic paraganglioma and multiple liver metastases who had received chemotherapy and lived for 4 years. 8 , 19 In our case, although the patient had peripheral tumor invasion, no recurrence or metastasis was found on short-term reexamination.…”

Section: Discussionmentioning

confidence: 43%

CT and MR Imaging Findings of Pancreatic Paragangliomas

Liang

Xu²

2016

Medicine

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Previous studies on pancreatic paraganglioma, a rare neoplasm, have primarily reported its ultrasound and routine and contrast-enhanced computed tomography (CT) findings. To our knowledge, we are the first to report the contrast-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) sequence findings of pancreatic paraganglioma.A male patient, ages 41 years, was admitted to our hospital due to a pancreatic space-occupying lesion that had been present for more than 10 days. The patient had no obvious discomfort. He had a history of hypertension and hyperthyroidism. Physical examination revealed upper abdominal tenderness without a palpable mass. Routine and contrast-enhanced abdominal CT showed a soft tissue mass at the pancreatic head/uncinate process, with patchy calcification within the lesion. On a contrast-enhanced CT scan, severe enhancement of the mass in the arterial phase was noted, as was slightly reduced but still marked enhancement in the venous phase. The celiac trunk and superior mesenteric artery segment were wrapped by the tumor. Thickened, tortuous vessels were observed at the lesion edges, around which there were multiple enlarged lymph nodes. The main pancreatic duct was markedly dilated. Routine and contrast-enhanced pancreatic MRI demonstrated an abnormal nodular signal in the pancreatic head/uncinate process that was approximately 4.3 × 6.4 cm2 in size. T1-weighted imaging (T1WI) revealed hypointensity, whereas T2-weighted imaging (T2WI) revealed nonhomogeneous, slight hyperintensity. Patchy hypointensity on both T1WI and T2WI was observed within the lesion. DWI showed slight hyperintensity. Grossly heterogeneous enhancement of the mass was observed on a contrast-enhanced MRI scan, with the tumor wrapped around the adjacent vasculature, and multiple enlarged lymph nodes were observed peripherally. After preoperative preparation, the patient underwent pancreatoduodenectomy. Histopathology and immunohistochemistry of the resected tumor indicated pancreatic paraganglioma. After surgery, the patient recovered well, without presenting any recurrence or metastasis during short-term follow-up.For hypervascular pancreatic tumors on contrast-enhanced CT or MRI, and particularly those occurring in the pancreatic head, with a clear display of draining veins, the possibility of pancreatic paraganglioma should be considered. These tumors usually exhibit necrosis or cystic changes and are occasionally accompanied by calcification.

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“…The average age reported in the literature for the detection of extra-adrenal pancreatic paragangliomas is 67 years (range, 42–85 years) [1]. Primary paragangliomas of the pancreas are extremely rare, with only 16 cases having been reported in the literature [3,4]. In the previously reported 16 primary pancreatic paragangliomas, there was only one case that was considered malignant with lymph node metastasis and one case that showed hormonal activity [1,5].…”

Section: Introductionmentioning

confidence: 99%

Malignant extra-adrenal pancreatic paraganglioma: case report and literature review

et al. 2013

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BackgroundPancreatic paragangliomas are rare tumors, with only 16 reported cases to date. One of these cases demonstrates metastasis to lymph node, while another case was functional, however, none of these cases showed malignant and large, pancreatic paraganglioma with marked invasion. Also another unique feature was the age of our patient compared to the average reported ages in published literature (42–85 years).Case presentationA 19-year-old woman presented with a one-year history of intermittent abdominal pain. Physical examination showed a palpable mass in the right upper abdomen, but initial laboratory results were within normal ranges; tumor markers (CEA, AFP, and CA19-9) were negative. An abdominal and pelvic computed tomography (CT) scan showed a well-defined retroperitoneal para-aortic mass. The CT scan revealed that the surrounding lymph nodes were not enlarged, but the liver showed evidence of parenchymal infiltration. Intraoperatively, a large, firm tumor originating from the head of pancreas was found pushing on the caudate hepatic lobe and the inferior vena cava (IVC). The tumor was resected through a pancreaticoduodenectomy, involving segment VI of the liver and a small segment of the IVC. The blood pressure spiked (>220 mm Hg) when the tumor was manipulated during the operation. The final pathology report showed a 9-cm tumor with lymphovascular invasions; immunohistochemistry was positive for synaptophysin and chromogranin. All resection margins were negative and 1/15 lymph nodes was positive for metastasis. Post-operative recovery was unremarkable. One month after discharge, the patient was re-admitted with abdominal pain and found to have an abdominal collection at the resection site, which was drained under CT guidance. She received a therapeutic dose of I131-metaiodobenzylguanidine (MIBG). Follow-ups showed the absence of recurrence, and she has remained disease free.ConclusionThis patient was an extraordinary example of a rare tumor. Even more remarkable was that the tumor was malignant with lymph node invasion. To our knowledge, a case similar to that presented here has not been previously reported in the literature.

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Cited by 25 publications

References 5 publications

A Case of Primary Paraganglioma that Arose in the Pancreas: the Color Doppler Ultrasonography and Dynamic CT Features

A Case of Primary Paraganglioma that Arose in the Pancreas: the Color Doppler Ultrasonography and Dynamic CT Features

CT and MR Imaging Findings of Pancreatic Paragangliomas

Malignant extra-adrenal pancreatic paraganglioma: case report and literature review

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