Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2015; 7(8): 170-173
Published online Aug 27, 2015. doi: 10.4240/wjgs.v7.i8.170
Large gangliocytic paraganglioma of the duodenum: A rare entity
Alejandra Gordillo Hernández, Eduardo Dominguez-Adame Lanuza, Auxiliadora Cano Matias, Rosario Perez Huertas, Katherine Maria Gallardo Rodriguez, Purificacion Gallinato Perez, Fernando Oliva Mompean
Alejandra Gordillo Hernández, Auxiliadora Cano Matias, Rosario Perez Huertas, Fernando Oliva Mompean, Servicio de Cirugia General, Hospital Universitario Virgen de Macarena, 41009 Sevilla, Spain
Eduardo Dominguez-Adame Lanuza, Jefe de Sección de Cirugia Laparoscopica Avanzada y Cirugía Bariatrica, Hospital Universitario Virgen de Macarena, 41009 Sevilla, Spain
Katherine Maria Gallardo Rodriguez, Purificacion Gallinato Perez, Servicio de Anatomia Patologica, Hospital Universitario Virgen de Macarena, 41009 Sevilla, Spain
Author contributions: Gordillo Hernández A designed and performed the research, and wrote the paper; Gallardo Rodriguez KM, Gallinato Perez P, Cano Matias A, Perez Huertas R, Oliva Mompean F and Dominguez-Adame Lanuza E contributed new reagents or analytic tools; Gordillo Hernández A and Gallardo Rodriguez KM analyzed the data.
Institutional review board statement: The study was reviewed and approved by the Hospital Universitario Virgen de Macarena Review Committee.
Informed consent statement: The patient provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alejandra Gordillo Hernández, MD, Servicio de Cirugia General, Hospital Universitario Virgen de Macarena, Avenida Doctor Fedriani 3, 41009 Sevilla, Spain. alejandragordillo@hotmail.com
Telephone: +34-658-154289 Fax: +34-954-557347
Received: March 24, 2015
Peer-review started: March 26, 2015
First decision: April 27, 2015
Revised: May 14, 2015
Accepted: June 4, 2015
Article in press: June 8, 2015
Published online: August 27, 2015
Processing time: 160 Days and 23 Hours
Abstract

Gangliocytic paragangliomas are rare tumors that almost exclusively occur within the second portion of the duodenum. Although these tumors generally have a benign clinical course, they have the potential to recur or metastasize to regional lymph nodes. The case report presented here describes a 57-year-old female patient with melena, progressive asthenia, anemia, and a mass in the second-third portion of the duodenum that was treated by local excision. The patient was diagnosed with a friable bleeding tumor. The histologic analysis showed that the tumor was a 4 cm gangliocytic paraganglioma without a malignant cell pattern. In the absence of local invasion or distant metastasis, endoscopic resection represents a feasible, curative therapy. Although endoscopic polypectomy is currently considered the treatment of choice, it is not recommended if the size of the tumor is > 3 cm and/or there is active or recent bleeding. Patients diagnosed with a gangliocytic paraganglioma should be closely followed-up for possible local recurrence.

Keywords: Duodenum; Gangliocytic paraganglioma; Ganglion cells

Core tip: We present the case of a patient with a rare duodenal gangliocytic paraganglioma that was treated by tumorectomy. Although there is currently no consensus for treatment, this report demonstrates that local conservative tumorectomy is a feasible, curative therapy. Patients diagnosed with a gangliocytic paraganglioma should be closely followed-up for possible local recurrence.