A Case Report of Duodenal Gangliocytic Paraganglioma with Lymph Node Metastasis

Naoki Takabayashi, Taizo Kimura, Masayuki Yoshida, Shunji Sakuramachi, Yukio Harada, Isamu Kino*

First Department of Surgery, First Department of Pathology*
Hamamatsu University School of Medicine

A case of duodenal gangliocytic paraganglioma with lymph node metastasis is reported. The patient was a 63-year-old woman who complained of epigastralgia. Sonographic examination showed biliary dilatation, and a tumor was found in the third portion of the duodenum by endoscopy and hypotonic duodenography. The tumor was covered by duodenal mucosa with multifocal ulceration. Pylorus-preserving pancreatoduodenectomy was performed. The diagnosis of gangliocytic paraganglioma was made histologically and by immunohistochemical findings (positivity for NSE, S-100 protein, somatostain and others). These examinations also revealed micrometastasis in a regional lymph node. In the literature, 6 cases of gangliocytic paraganglioma with lymph node metastasis have been reported. The postoperative course was good in these cases, and no recurrence was documented. It is thought that extended resection is not necessary for this lesion.

Key words
lymph node metastasis of duodenal gangliocytic paraganglioma, doudenal tumor, duodenal gangliocytic paraganglioma

Reprint requests
Naoki Takabayashi First Department of Surgery, Hamamatsu University School of Medicine
3600 Handa-cho, Hamamatsu, 431-31 JAPAN

Accepted
May 11, 1993

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