Segmental Groove Pancreatitis and Duodenal Gangliocytic Paraganglioma With Lymph Node Metastasis

Fiscaletti, Marta; Fornelli, Adele; Zanini, Nicola; Fabbri, Carlo; Collina, Guido; Lega, Stefania; Stasi, G; Jovine, Elio

doi:10.1097/mpa.0b013e31821f54d6

Cited by 8 publications

(2 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In another patient found to have segmental groove pancreatitis secondary to a compressive ampullary GP, the initial FNA of a cystic mass-like lesion in the head of the pancreas was determined to be consistent with pancreatitis. FNA of the actual tumor was not performed[25]. In the remaining six cases, FNA was either diagnostic of a GP or carcinoid/neuroendocrine tumor[12,14,19,26,32].…”

Section: Discussionmentioning

confidence: 99%

Duodenal gangliocytic paraganglioma with lymph node metastases: a case report and comparative review of 31 cases

Cathcart

Sasson

Kozel

et al. 2017

WJCC

View full text Add to dashboard Cite

Gangliocytic paraganglioma (GP) is a rare tumor of uncertain origin most often located in the second portion of the duodenum. It is composed of three cellular components: Epithelioid endocrine cells, spindle-like/sustentacular cells, and ganglion-like cells. While this tumor most often behaves in a benign manner, cases with metastasis are reported. We describe the case of a 62-year-old male with a periampullary GP with metastases to two regional lymph nodes who was successfully treated with pancreaticoduodenectomy. Using PubMed, EMBASE, EBSCOhost MEDLINE and CINAHL, and Google Scholar, we searched the literature for cases of GP with regional lymph node metastasis and evaluated the varying presentations, diagnostic workup, and disease management of identified cases. Thirty-one cases of GP with metastasis were compiled (30 with at least lymph node metastases and one with only distant metastasis to bone), with age at diagnosis ranging from 16 to 74 years. Ratio of males to females was 19:12. The most common presenting symptoms were abdominal pain (55%) and gastrointestinal bleeding or sequelae (42%). Twenty-five patients underwent pancreaticoduodenectomy. Five patients were treated with local resection alone. One patient died secondary to metastatic disease, and one died secondary to perioperative decompensation. The remainder did well, with no evidence of disease at follow-up from the most recent procedure (except two in which residual disease was deliberately left behind). Of the 26 cases with sufficient histological description, 16 described a primary tumor that infiltrated deep to the submucosa, and 3 described lymphovascular invasion. Of the specific immunohistochemistry staining patterns studied, synaptophysin (SYN) stained all epithelioid endocrine cells (18/18). Neuron specific enolase (NSE) and SYN stained most ganglion-like cells (7/8 and 13/18 respectively), and S-100 stained all spindle-like/sustentacular cells (21/21). Our literature review of published cases of GP with lymph node metastasis underscores the excellent prognosis of GP regardless of specific treatment modality. We question the necessity of aggressive surgical intervention in select patients, and argue that local resection of the mass and metastasis may be adequate. We also emphasize the importance of pre-surgical assessment with imaging studies, as well as post-surgical follow-up surveillance for disease recurrence.

show abstract

Section: Discussionmentioning

confidence: 99%

Duodenal gangliocytic paraganglioma with lymph node metastases: a case report and comparative review of 31 cases

Cathcart

Sasson

Kozel

et al. 2017

WJCC

View full text Add to dashboard Cite

show abstract

“…Of the cases that reported presenting symptoms, abdominal pain was the most common (57%), followed by gastrointestinal bleeding/anemia (43%), weight loss (13%), obstructive jaundice (10%), pancreatitis (7%), duodenal obstruction (7%), and incidental (7%). Past medical history reported two patients with alcohol abuse, two patients with tobacco use, and two cases having the genetic traits of thalassemia and familial spastic paresis [12][13][14][15] (Table 1).…”

Section: Patient Demographics and Characteristicsmentioning

confidence: 99%

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

Hartford

Sherazadishvili

Leslie

2016

Int J Hepatobiliary Pancreat Dis

View full text Add to dashboard Cite

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.

show abstract

Neuroendocrine Tumors (NETs) of the Minor Papilla/Ampulla

Vanoli

Albarello

Uncini

et al. 2019

American Journal of Surgical Pathology

View full text Add to dashboard Cite

Neuroendocrine tumors (NETs) of the minor papilla/ampulla (MIPA) are rare and poorly studied. Only individual case reports and no comprehensive analysis are available from the literature. We collected 16 MIPA NETs and investigated their clinicopathologic and immunohistochemical features, including markers such as somatostatin, pancreatic polypeptide, gastrin, serotonin, MUC1, cytokeratin 7, and somatostatin receptors type 2A and 5. The median age at diagnosis was 57.5 years, and the female-to-male ratio was 2.2:1. The median NET size was 1.45 cm, and most (94%) were low-grade (G1) tumors. Similarly to what was observed in the major ampulla, 3 histotypes were found: (i) ampullary-type somatostatin-producing tumors (ASTs, 10 cases), characterized by somatostatin expression in most tumor cells, focal-to-extensive tubulo-acinar structures, often with psammoma bodies, MUC1 reactivity, and no or rare membranous reactivity for somatostatin receptor type 2A; (ii) gangliocytic paragangliomas (3 cases), characterized by the coexistence of 3 tumor cell types: epithelioid, often reactive for pancreatic polypeptide, ganglion-like cells, and S100 reactive sustentacular/stromal cells; and (iii) ordinary nonfunctioning NETs (3 cases), resembling those more commonly observed in the extra-ampullary duodenum. Comparable histotypes could also be recognized among the 30 MIPA NETs from the literature. No NET-related patient death among MIPA cases was observed during a median follow-up of 38 months; however, MIPA ASTs showed lymph node metastases and invasion of the duodenal muscularis propria or beyond in 44% and 40% of cases, respectively. In conclusion, MIPA NETs closely resemble tumors arising in the major ampulla, with predominance of ASTs.

show abstract

Segmental Groove Pancreatitis and Duodenal Gangliocytic Paraganglioma With Lymph Node Metastasis

Cited by 8 publications

References 8 publications

Duodenal gangliocytic paraganglioma with lymph node metastases: a case report and comparative review of 31 cases

Duodenal gangliocytic paraganglioma with lymph node metastases: a case report and comparative review of 31 cases

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

Neuroendocrine Tumors (NETs) of the Minor Papilla/Ampulla

Contact Info

Product

Resources

About