Duodenal gangliocytic
paraganglioma: a radiological-pathological correlation.Ann
Diagn Pathol. 2005 Jun;9(3): 143-7.
Duodenal
gangliocytic paraganglioma is a rare tumor that characteristically
occurs in the second portion of the duodenum and typically presents
with gastrointestinal bleeding. Gangliocytic paragangliomas have a
characteristic triphasic microscopic appearance with epithelioid
cells, spindle cells, and ganglion cells, resulting in a complex
histology with features of paraganglioma, carcinoid, and
ganglioneuroma. Duodenal gangliocytic paragangliomas have an excellent
prognosis after surgical resection but metastatic spread to regional
lymph nodes and recurrence may rarely occur. We report a case of
duodenal gangliocytic paraganglioma and discuss the radiological and
pathological differential diagnosis of this rare entity.
Duodenal
somatostatinoma: clinical and immunohistochemical patterns--difficult
differential diagnosis in regard to gangliocytic paraganglioma: report
of a case.Eur
J Med Res. 2005 Mar 29;10(3):135-8.
The authors
report a large duodenal somatostatinoma, a very rare tumor entity. A
8.5 cm globular mass in the area of the unicate process of the
pancreas was detected in a 45 year old caucasian female by
computerized tomography. The patient had only mild complaints. Initial
treatment consisted of right pancreatectomy with preservation of the
pylorus. Histological evaluation rendered a diagnosis of low-grade
malignant neuroendocrine carcinoma with expression of somatostatin,
respectively of somatostatinoma arising in the duodenum and
infiltrating into the pancreas. 26 months after the initial surgery
liver and lymph node metastases were detected and surgically removed.
This case confirms that duodenal somatostatinomas are very difficult
to diagnose preoperatively because of unspecific symptoms. Most
duodenal somatostatinomas are found incidentally. Treatment of choice
is radical surgical resection with a possible cure in early stages of
the disease. Even a large tumor as ours is resectable with negative
surgical margins. Management of recurrent or metastatic disease is
also surgical. Additional chemotherapy and supportive care may be
beneficial for the patient. |
