[A case of gangliocytic paraganglioma in duodenum].
Duodenal gangliocytic paraganglioma derived from neural crest is a peculiar neuroendocrine tumor. It is incidentally found during radiographic studies or due to gastrointestinal hemorrhage caused by frequent ulceration of the overlying mucosa. Most lesions are pedunculated and submucosal with distinctive histology consisting of endocrine cells, ganglion cells and spindle-shaped Schwann cells. We experienced a duodenal gangliocytic paraganglioma in a 40-year-old woman presenting with episodes of melena. Esophagogastroduodenoscopy revealed a submucosal ulcerated tumor in the second portion of duodenum and a biopsy confirmed gangliocytic paraganglioma. The tumor was enucleated through a duodenotomy. It's size was 5.5 X 3 X 1.5 cm sized and revealed positive cellular reaction for chromogranin, synaptophysin, neuron-specific enolase, and neurofilament by immunohistochemistry. The majority of the reported duodenal gangliocytic paraganglioma were of benign nature. Therefore, radical surgery or a lymph node dissection could be avoided if that disease was confirmed. However, thorough investigation for lymph node metastasis and postoperative follow-up are needed. We report the first case of a duodenal gangliocytic paraganglioma in Korea with a review of literature.
Kim
Jie Hyun
JH
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Kim
Hee Man
HM
Song
Si Young
SY
Kim
Yoon Jae
YJ
Hahn
Chang Hoon
CH
Park
Seung Woo
SW
Chung
Jae Bock
JB
Kang
Jin Kyung
JK
Lee
Woo Jung
WJ
Cho
Nam Hoon
NH
D000328:Adult; D004379:Duodenal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D010235:Paraganglioma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery