Gangliocytic Paraganglioma of the Minor Papilla of the Duodenum

Intern Med. 2017;56(9):1029-1035. doi: 10.2169/internalmedicine.56.7812. Epub 2017 May 1.

Abstract

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.

Keywords: diagnosis; duodenum; gangliocytic paraganglioma; minor papilla; prognosis; treatment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy
  • Duodenal Neoplasms / diagnostic imaging*
  • Duodenal Neoplasms / pathology
  • Duodenal Neoplasms / surgery*
  • Endosonography
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Pancreatic Ducts / diagnostic imaging*
  • Pancreatic Ducts / surgery*
  • Paraganglioma / diagnostic imaging*
  • Paraganglioma / pathology
  • Paraganglioma / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome