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

Table 3 Treatment recommendations for a duodenal gangliocytic paraganglioma

Ampullary/ periampullary mass	EUS with FNA to rule out pancreatic adenocarcinoma, followed by pancreaticoduodenectomy with resection of suspicious lymph nodes
Duodenal mass, away from pancreas	CT to evaluate disease extent +/- FNA with local resection of primary tumor and suspicious lymph nodes if tumor location permits
Complete resection unattainable and/or surgically unfit candidate	Imaging modality + FNA/biopsy to establish diagnosis, octreotide scan, and trial of medical management with somatostatin analogues
	Tumor debulking should be attempted if surgically fit

EUS: Endoscopic ultrasound; CT: Computed tomography; FNA: Fine needle aspiration.