Successful endoscopic resection of a gangliocytic paraganglioma of the minor papilla in a patient with pancreas divisum and pancreatitis (with video)

Loew, Burr J.; Lukens, Frank; Navarro, Fernando A.; Roy, Michael J.; Mattia, Anthony R.; Howell, Douglas A.

doi:10.1016/j.gie.2006.07.019

Cited by 18 publications

(9 citation statements)

References 22 publications

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“…It has been hypothesized that a hamartoma-like mechanism is involved in the development of GP from misplaced embryonic pancreatic tissue (1,49,50). Although there are only two reported cases of a GP of the duodenal minor papilla (11,51), this theory can be compatible with the viewpoint of its favored location, as the endocrine cell micronest and (ectopic) pancreatic tissue are often recognized within the minor papilla (52). However, the high incidence in the duodenum and not the pancreas suggests that some other factors remain to be elucidated (e.g., digestive or chemical stimuli such as pancreatic juice and/or bile exposure).…”

Section: Discussionmentioning

confidence: 61%

Gangliocytic Paraganglioma of the Minor Papilla of the Duodenum

et al. 2017

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A duodenal polyp was found during a health check of a 71-year-old asymptomatic man. Duodenoscopy demonstrated a pedunculated, smooth-surfaced tumor of 18 mm in size, protruding from the minor papilla. Endoscopic ultrasonography demonstrated a homogeneously low-echoic submucosal tumor. Enhanced computed tomography and magnetic resonance imaging demonstrated a well-enhanced duodenal tumor without obvious metastasis. A tumor biopsy revealed a well-differentiated neuroendocrine tumor, and laparotomic transduodenal polypectomy with regional lymph node dissection was performed. The histology of the surgical specimen revealed gangliocytic paraganglioma consisting of three cell types: endocrine, ganglion, and spindle cells. There has been no recurrence in >5 years after surgery.

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Section: Discussionmentioning

confidence: 61%

Gangliocytic Paraganglioma of the Minor Papilla of the Duodenum

et al. 2017

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“…GP is well defined by ultrasonography and is visualized as a hypoechoic mass. GPs are considered benign even though they occasionally involve the regional lymph nodes and display distant metastasis or tumor recurrence, features suggestive of malignancy [1,8]. The characteristic ulceration and bleeding of the overlying mucosa lead to the usual clinical manifestations of melena and sometimes massive hematemesis and unexplained anemia [9].…”

Section: Discussionmentioning

confidence: 99%

A case of ampullary gangliocytic paraganglioma

Yang

Choi

Lee

et al. 2014

Korean J Intern Med

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Gangliocytic paragangliomas (GPs) are rare tumors of the duodenum, presenting as single sessile or pedunculated polypoid masses. Clinical manifestations of duodenal GPs can vary from an incidental finding at endoscopy to frequent upper gastrointestinal bleeding caused by mucosal ulceration and abdominal pain. GPs are considered benign, but the disease can recur and spread to regional lymph nodes. A 41-year-old female presented with abdominal pain. Upper gastrointestinal endoscopy revealed a subepithelial tumor of the ampulla of Vater in the second portion of the duodenum. The tumor was resected using the endoscopic mucosal resection technique. The tumor was diagnosed as benign GP of the duodenum using histological and immunohistochemical staining procedures.

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“…(1) Small (< 2 cm) tumors without evidence of peritumoral lymph nodes on CT scan could be treated by endoscopic mucosal resection [11,38,39], surgical resection by ampullectomy [1,40], or laparoscopic transduodenal tumorectomy in combination with preoperative duodenoscopy [41]. (2) In case of large tumors, suspicion of metastatic lymph nodes or histological features such as infiltrative margins on local resection, nuclear pleomorphism, or high mitotic activity [25] duodenopancreatectomy with lymph node dissection should be performed.…”

Section: Discussionmentioning

confidence: 99%

Duodenal gangliocytic paraganglioma with lymph node metastasis and an 8-year follow-up

Barret¹,

Rahmi²,

Huyen³

et al. 2012

European Journal of Gastroenterology & Hepatology

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Gangliocytic paraganglioma (GP) is a rare tumor, usually located in the second part of the duodenum. On pathological examination, GP is characterized by the association of the histological features of paragangliomas, ganglioneuromas, and carcinoid tumors. Classical clinical presentations are upper gastrointestinal bleeding and abdominal pain. Preoperative diagnosis is difficult because of the submucosal site of the tumor, with usually negative mucosal biopsies. Endoscopic ultrasound helps establish the diagnosis and allows lymph node staging, which will guide the choice of the treatment. If GPs usually follow a benign course, metastatic spread to regional lymph nodes treated by surgical resection alone has been reported. We report a case of GP with lymph node metastases treated by duodenopancreatectomy with long-term disease-free survival, suggesting that surgical resection is a reasonable approach for metastatic GPs.

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Successful endoscopic resection of a gangliocytic paraganglioma of the minor papilla in a patient with pancreas divisum and pancreatitis (with video)

Cited by 18 publications

References 22 publications

Gangliocytic Paraganglioma of the Minor Papilla of the Duodenum

Gangliocytic Paraganglioma of the Minor Papilla of the Duodenum

A case of ampullary gangliocytic paraganglioma

Duodenal gangliocytic paraganglioma with lymph node metastasis and an 8-year follow-up

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