Duodenal gangliocytic paraganglioma with lymph node metastasis: A systematic case review

Abstract

Introduction:Duodenal gangliocytic paragangliomas (DGPs) are rare tumors, most commonly located in the 2nd portion of the duodenum. Their origin is poorly understood and management is uncertain. Typically benign, they infrequently metastasize to lymph node and distant sites. Objective: A systematic literature search for DGPs with lymph node metastases was performed. Epidemiological, diagnostic, management, surveillance and outcome data were recorded. The histopathology and immunohistochemistry of these tumors and possible predictors of lymph node metastases were revisited. Thirty three cases of DGPs with lymph node metastases were included.

Duodenal gangliocytic paraganglioma: A case report

“…Computed tomography (CT) scan of the abdomen and pelvis and endoscopic ultrasound (EUS) are done for staging and serve to R/o invasion of lymph nodes, as 47% and 64% of lymph nodes positivity are detected respectively by CT and EUS [11]. Our patient didn't have positive lymph node (LN) on scan that's why a LN dissection wasn't performed.…”

“…The lesion can be found incidentally. It can present also with nausea, weight loss, fatigue, or jaundice [11].…”

“…Our patient didn't have positive lymph node (LN) on scan that's why a LN dissection wasn't performed. Other types of imaging have been used to detect a DGP such as gastrografin swallow, magnetic resonance imaging (MRI), intraoperative US, positron emission tomography (PET), Octreotide scan, but they are less specific than CT and EUS for detecting LN [11].…”

“…If the tumor is <5 cm, suspended by a stalk, and with no suspicion of positive lymph nodes, then an endoscopic resection can be conducted, although many experts argue against this technique [11]. If the tumor is peri-ampullary, >5cm, no stalk or suspicion of positive lymph nodes by imaging then a surgical resection with lymph node dissection must be conducted.…”