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Zhao Z, Guo Y, Liu L, Zhang L, Li S, Yang J. Primary non-functional pancreatic paraganglioma: A case report and review of the literature. J Int Med Res 2022; 50:3000605221143023. [PMID: 36562124 PMCID: PMC9793047 DOI: 10.1177/03000605221143023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Primary pancreatic paragangliomas are rare. They are mainly non-functional tumours that lack typical clinical manifestations. Definite diagnosis relies on histopathology and immunohistochemistry, and the main treatment is surgery. We report here a case of primary, non-functional, pancreatic paraganglioma in a 49-year-old woman. The tumour was approximately 5.0 × 3.2 ×4.7 cm in size and located in the pancreatic neck and body. We undertook 3D laparoscopic complete resection of the tumour. The patient developed a pancreatic fistula (biochemical leak) post-surgery, but she recovered and was discharged from hospital 11 days after surgery. We describe this case study and briefly summarize previous related reports.
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Affiliation(s)
- Zhanxue Zhao
- Medical College of Soochow University, Suzhou 215123, Jiangsu
Province, China,Department of General Surgery, Qinghai Provincial People's
Hospital, Xining 810007, Qinghai Province, China
| | - Yan Guo
- Department of Pathology, Qinghai Provincial People's Hospital,
Xining 810007, Qinghai Province, China
| | - Linxun Liu
- Department of General Surgery, Qinghai Provincial People's
Hospital, Xining 810007, Qinghai Province, China
| | - Linming Zhang
- Department of MRI, Qinghai Provincial People's Hospital, Xining
810007, Qinghai Province, China
| | - Shuai Li
- Department of Clinical Pharmacy, Affiliated Hospital of Qinghai
University, Xining 810007, Qinghai Province, China
| | - Jinyu Yang
- Department of General Surgery, Qinghai Provincial People's
Hospital, Xining 810007, Qinghai Province, China,Jinyu Yang, Department of General Surgery,
Qinghai Provincial People's Hospital, Xining, Qinghai 810007, China.
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2
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Li T, Yi RQ, Xie G, Wang DN, Ren YT, Li K. Pancreatic paraganglioma with multiple lymph node metastases found by spectral computed tomography: A case report and review of the literature. World J Clin Cases 2022; 10:11638-11645. [PMID: 36387819 PMCID: PMC9649556 DOI: 10.12998/wjcc.v10.i31.11638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/29/2022] [Accepted: 10/09/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Primary pancreatic paraganglioma is exceedingly rare. Most patients with pancreatic paraganglioma lack a typical clinical presentation, and the tumor is difficult to accurately differentiate from other pancreatic neuroendocrine tumors, making the misdiagnosis rate extremely high. Surgical excision is the primary treatment modality but is considered high risk. Because of its rich vascularity, the tumor easily bleeds during surgery, especially malignant paragangliomas invading large blood vessels. Thus, a thorough preoperative evaluation of the tumor is necessary. Here, we report a primary malignant pancreatic paraganglioma, the second such case in a young patient that was successfully resected surgically.
CASE SUMMARY A 26-year-old female patient was admitted to the hospital with unexplained abdominal pain. Dual-layer spectral-detector computed tomography (DLCT) revealed a mixed density mass in the pancreatic body and tail. The patient was transferred to our hospital after previous failed surgical resection at other hospitals. The patient and her family strongly desired surgery. After a thorough preoperative evaluation and adequate preparation, a large mass with the greatest dimension of 8.0 cm was successfully resected. The final pathological diagnosis was malignant paraganglioma. The patient was discharged in good condition 2 wk postoperatively.
CONCLUSION The rare malignant pancreatic paraganglioma reported here was difficult to diagnose preoperatively. Early filling of the draining vein may be a crucial diagnostic imaging feature. DLCT can provide more precise information for surgical resection through dual-energy imaging.
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Affiliation(s)
- Ting Li
- Department of Medical Imaging, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Rong-Qi Yi
- Department of Radiology, Chongqing General Hospital, Chongqing 401147, China
| | - Gang Xie
- Department of Medical Imaging, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Dan-Ni Wang
- Department of Medical Imaging, Chongqing Medical University, Chongqing 400016, China
| | - Yi-Tao Ren
- Department of Medical Imaging, Chongqing Medical University, Chongqing 400016, China
| | - Kang Li
- Department of Radiology, Chongqing General Hospital, Chongqing 401147, China
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Wang L, Zhang YN, Chen GY. Bladder paraganglioma after kidney transplantation: A case report. World J Clin Cases 2022; 10:9044-9049. [PMID: 36157666 PMCID: PMC9477062 DOI: 10.12998/wjcc.v10.i25.9044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/25/2022] [Accepted: 07/29/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Kidney transplantation is associated with an increased risk of tumors in the urinary bladder. Among all the pathological types of tumors in the bladder, paraganglioma, which arises from extra-adrenal paraganglia and consists of chromaffin cells, is rare. Paragangliomas might cause severe clinical symptoms due to catecholamine hypersecretion or mass compression. Bladder paragangliomas are rare, especially those appearing after kidney transplantation. Here, we report a case of bladder paraganglioma developing after kidney transplantation.
CASE SUMMARY A 63-year-old woman received a kidney transplant 12 years ago and took oral immunosuppressants (cyclosporine, mizoribine, and methylprednisolone) for regular post-transplant treatment. The patient felt no discomfort and she came to the hospital for a routine checkup. A mass located in the bladder was incidentally discovered by computed tomography, and she underwent surgical treatment. A 2 cm × 2 cm invasive mass was found in the trigone of the bladder and the mass was removed. The diagnosis of paraganglioma was confirmed by morphology and immunophenotyping. The patient had a good prognosis and is still alive.
CONCLUSION Paraganglioma can grow in the bladder, which might cause no clinical symptoms. The diagnosis mainly depends on morphology and immunophenotyping. Surgical resection is an important treatment option for such patients.
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Affiliation(s)
- Lin Wang
- Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Yan-Ning Zhang
- Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Guang-Yong Chen
- Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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Petrelli F, Fratini G, Sbrozzi-Vanni A, Giusti A, Manta R, Vignali C, Nesi G, Amorosi A, Cavazzana A, Arganini M, Ambrosio MR. Peripancreatic paraganglioma: Lesson from a round table. World J Gastroenterol 2022; 28:2396-2402. [PMID: 35800185 PMCID: PMC9185219 DOI: 10.3748/wjg.v28.i21.2396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/18/2022] [Accepted: 05/14/2022] [Indexed: 02/06/2023] Open
Abstract
We described the case of a peripancreatic paraganglioma (PGL) misdiagnosed as pancreatic lesion. Surgical exploration revealed an unremarkable pancreas and a large well-defined cystic mass originating at the mesocolon root. Radical enucleation of the mass was performed, preserving the pancreatic tail. Histologically, a diagnosis of PGL was rendered. Interestingly, two previously unreported mutations, one affecting the KDR gene in exon 7 and another on the JAK3 gene in exon 4 were detected. Both mutations are known to be pathogenetic. Imaging and cytologic findings were blindly reviewed by an expert panel of clinicians, radiologists, and pathologists to identify possible causes of the misdiagnosis. The major issue was lack of evidence of a cleavage plane from the pancreas at imaging, which prompted radiologists to establish an intra-parenchymal origin. The blinded revision shifted the diagnosis towards an extra-pancreatic lesion, as the pancreatic parenchyma showed no structural alterations and no dislocation of the Wirsung duct. Ex post, the identified biases were the emergency setting of the radiologic examination and the very thin mesocolon sheet, which hindered clear definition of the lesion borders. Original endoscopic ultrasonography diagnosis was confirmed, emphasizing the intrinsic limit of this technique in detecting large masses. Finally, pathologic review favored a diagnosis of PGL due to the morphological features and immonohistochemical profile. Eighteen months after tumor excision, the patient is asymptomatic with no disease relapse evident by either radiology or laboratory tests. Our report strongly highlights the difficulties in rendering an accurate pre-operative diagnosis of PGL.
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Affiliation(s)
- Federica Petrelli
- Pathology Unit, Azienda Sanitaria Toscana Nord Ovest, Pisa 56121, Italy
| | - Geri Fratini
- Surgery Unit, Azienda Sanitaria Toscana Nord Ovest, Pisa 56121, Italy
| | | | - Andrea Giusti
- Pathology Unit, Azienda Sanitaria Toscana Nord Ovest, Pisa 56121, Italy
| | - Raffele Manta
- Endoscopic Unit, Santa Maria Misericordia Hospital, Perugia 06122, Italy
| | - Claudio Vignali
- Interventional Radiology Unit, Azienda Sanitaria Toscana Nord Ovest, Pisa 56121, Italy
| | - Gabriella Nesi
- Department of Health Sciences, University of Florence, Florence 50139, Italy
| | - Andrea Amorosi
- Pathology Unit, Università Magna Graecia, Catanzaro 88100, Italy
| | - Andrea Cavazzana
- Pathology Unit, Azienda Sanitaria Toscana Nord Ovest, Pisa 56121, Italy
| | - Marco Arganini
- Surgery Unit, Azienda Sanitaria Toscana Nord Ovest, Pisa 56121, Italy
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Dai B, He J, Zhu X, Xie Z, Zhang C, Zhou X, Yang Z, Wang J. An Analysis of Computed Tomography Imaging Features and Predictive Factors for Postoperative Recurrence and Metastasis of Abdominal Paragangliomas. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:8638588. [PMID: 35280711 PMCID: PMC8885278 DOI: 10.1155/2022/8638588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/11/2022] [Accepted: 01/15/2022] [Indexed: 11/17/2022]
Abstract
Methods We studied 51 abdominal PGL patients at the First Affiliated Hospital of Bengbu Medical College, Tongde Hospital, and Sir Run Shaw Hospital, Hangzhou, Zhejiang Province, China, from June 2009 to May 2019. Thereafter, the clinical research data, tumor biomarkers, and CT features were compared between the aggressive PGLs and the nonaggressive PGLs using independent-samples t-tests and chi-square tests. Results Of the 51 cases, 43 were benign and 8 had malignant tendencies. Postoperative recurrence and metastasis were more likely to occur when the tumor diameter was >8 cm or/and the enhancement degree was not obvious. Clinical symptoms, tumor markers, sex, age, and CT image characteristics including morphology, presence of cystic degeneration, "pointed peach" sign, calcification, hemorrhage, enlarged lymph nodes, and peritumor and intratumor blood vessels were not significantly different between the two groups (p > 0.05). Conclusion Our findings suggest that CT features, including size >8 cm and enhancement degree, could provide important evidence to assess risk factors for aggressive PGLs.
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Affiliation(s)
- Bailing Dai
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jie He
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiandi Zhu
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Zongyu Xie
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Cui Zhang
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xiaoli Zhou
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Zhao Yang
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Jian Wang
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
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Lanke G, Stewart JM, Lee JH. Pancreatic paraganglioma diagnosed by endoscopic ultrasound-guided fine needle aspiration: A case report and review of literature. World J Gastroenterol 2021; 27:6322-6331. [PMID: 34712035 PMCID: PMC8515802 DOI: 10.3748/wjg.v27.i37.6322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/28/2021] [Accepted: 09/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pancreatic paragangliomas (PPGL) are rare benign neuroendocrine neoplasms but malignancy can occur. PPGL are often misdiagnosed as pancreatic neuroendocrine tumor or pancreatic adenocarcinoma.
CASE SUMMARY We reviewed 47 case reports of PPGL published in PubMed to date. Fifteen patients (15/47) with PPGL underwent endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). Only six (6/15) were correctly diagnosed as PPGL. All patients with PPGL underwent surgical resection except three (one patient surgery was aborted because of hypertensive crisis, two patients had metastasis or involvement of major vessels). Our patient remained on close surveillance as she was asymptomatic.
CONCLUSION Accurate preoperative diagnosis of PPGL can be safely achieved by EUS-FNA with immunohistochemistry. Multidisciplinary team approach should be considered to bring the optimal results in the management of PPGL.
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Affiliation(s)
- Gandhi Lanke
- Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, Lubbock, TX 79407, United States
| | - John M Stewart
- Pathology-lab Medicine Division, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Jeffrey H Lee
- Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, Houston, TX 77030, United States
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Jiang CN, Cheng X, Shan J, Yang M, Xiao YQ. Primary pancreatic paraganglioma harboring lymph node metastasis: A case report. World J Clin Cases 2021; 9:8071-8081. [PMID: 34621864 PMCID: PMC8462202 DOI: 10.12998/wjcc.v9.i27.8071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/19/2021] [Accepted: 08/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary pancreatic paragangliomas are extremely rare tumors. Limited by the diagnostic efficacy of histopathological examination, their malignant behavior is thought to be associated with local invasion or metastasis, with only four malignant cases reported in the literature to date. As pancreatic paragangliomas share similar imaging features with other types of pancreatic neuroendocrine neoplasms, they are difficult to diagnose accurately without the support of pathological evidence. As primary pancreatic paragangliomas are rare, especially those accompanied by lymph node metastasis, there is currently no consensus on treatment. Herein, we report a case of primary pancreatic paraganglioma with lymph node metastasis.
CASE SUMMARY A mass located in the pancreatic body was incidentally discovered on computed tomography in a 41-year-old Tibetan man. Distal pancreatectomy was subsequently performed and a 4.1 cm × 4.2 cm tumor was found embedded in the body of the pancreas during surgery. Histological examination confirmed the characteristics of paraganglioma in which the neoplastic chief cells were arranged in a classic Zellballen pattern under hematoxylin-eosin staining. Further, immunohistochemistry demonstrated that the sustentacular cells in the tumor tissue were positive for S-100 protein, and neoplastic cells and pancreatic draining lymph nodes were positive for chromogranin A and synaptophysin; thus, the presence of lymph node metastasis (two of the eight resected pancreatic draining lymph nodes) was also confirmed. A diagnosis of primary pancreatic paraganglioma with lymph node metastasis was finally established. The patient remained disease-free for 1 year after the surgery.
CONCLUSION A definite diagnosis of pancreatic paraganglioma mainly depends on postoperative histopathological and immunohistochemical examinations. Surgical resection may be the first treatment of choice for patients with primary pancreatic paraganglioma that has metastasized to the lymph nodes.
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Affiliation(s)
- Cui-Nan Jiang
- Department of Hepatopancreatobiliary Surgery, Chengdu Third People’s Hospital, Chengdu 610031, Sichuan Province, China
| | - Xiao Cheng
- Department of Pathology, Chengdu Third People’s Hospital, Chengdu 610031, Sichuan Province, China
| | - Jing Shan
- Department of Gastroenterology, Chengdu Third People’s Hospital, Chengdu 610031, Sichuan Province, China
| | - Mei Yang
- Department of Gastroenterology, Chengdu Third People’s Hospital, Chengdu 610031, Sichuan Province, China
| | - Yu-Qing Xiao
- Department of Hepatopancreatobiliary Surgery, Chengdu Third People’s Hospital, Chengdu 610031, Sichuan Province, China
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Abbasi A, Wakeman KM, Pillarisetty VG. Pancreatic paraganglioma mimicking pancreatic neuroendocrine tumor. Rare Tumors 2020; 12:2036361320982799. [PMID: 33425308 PMCID: PMC7756035 DOI: 10.1177/2036361320982799] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022] Open
Abstract
Extra-adrenal paragangliomas are rare tumors arising from the chromaffin cells of the autonomic nervous system. Retroperitoneal paragangliomas may present as a pancreatic mass. We present a case of a 61-year-old woman with an incidentally found pancreatic mass (7.2 × 6.5 cm) in the CT scan. EUS- guided FNA result was compatible with pancreatic neuroendocrine tumor. Patient underwent pancreaticoduodenectomy and histopathologic assessment revealed the mass was an extra-adrenal paraganglioma. Preoperative diagnosis of pancreatic paragangliomas can be challenging due to imaging and histopathologic similarities with pancreatic neuroendocrine tumors.
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Affiliation(s)
- Arezou Abbasi
- Department of Surgery, University of Washington, Seattle, WA, USA
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Konukiewitz B, von Hornstein M, Jesinghaus M, Steiger K, Weichert W, Detlefsen S, Kasajima A, Klöppel G. Pancreatic neuroendocrine tumors with somatostatin expression and paraganglioma-like features. Hum Pathol 2020; 102:79-87. [PMID: 32668277 DOI: 10.1016/j.humpath.2020.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023]
Abstract
A small fraction of pancreatic neuroendocrine tumors (PanNETs) shows a solid, paraganglioma-like (PG-like) histology. We wanted to know whether these PanNETs have a special hormone expression and are related to paragangliomas (PGs)/pheochromocytomas (PCs). We screened a series of 48 surgically resected PanNETs for their histological growth patterns and their association with expression of islet hormones. The PanNETs were divided into PG-like and non-PG-like tumors and immunohistochemically monitored for the expression of islet hormones, cytokeratins, and S100. The results were correlated to histological pattern, lymph node status, and data in 28 PGs/PCs, including 2 PGs attached to the pancreas. All PanNETs, in contrast to PGs/PCs, were cytokeratin positive. A PG-like growth pattern was identified in 9 of 48 PanNETs and correlated with somatostatin expression. Only half of the non-PG-like PanNETs also contained somatostatin-positive cells. Eight of 28 PGs/PCs expressed somatostatin, mostly in individual cells. PG-like PanNETs and non-PG-like PanNETs infiltrated the adjacent pancreatic tissue, whereas 2 to the pancreas-associated PGs were well demarcated. Lymph node metastases were detected in 58%, 39%, 57%, and 53% of the somatostatin-producing, somatostatin-negative, PG-like, and non-PG-like PanNETs, respectively. PG-like PanNETs, in contrast to PG/PCs, are characterized by the expression of cytokeratin and somatostatin, the development of lymph node metastasis, and the infiltration into pancreatic parenchyma. Non-PG-like PanNETs may also express somatostatin and show lymph node metastases to the same extent. A literature review of cases reported as PG of the pancreas reveals that only a small fraction of these tumors probably represents true pancreatic PGs.
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Affiliation(s)
- Björn Konukiewitz
- Department of Pathology, Technical University of Munich, 81675, Munich, Germany.
| | | | - Moritz Jesinghaus
- Department of Pathology, Technical University of Munich, 81675, Munich, Germany.
| | - Katja Steiger
- Department of Pathology, Technical University of Munich, 81675, Munich, Germany.
| | - Wilko Weichert
- Department of Pathology, Technical University of Munich, 81675, Munich, Germany.
| | - Sönke Detlefsen
- Department of Pathology, Odense University Hospital, 5000, Odense, Denmark.
| | - Atsuko Kasajima
- Department of Pathology, Technical University of Munich, 81675, Munich, Germany.
| | - Günter Klöppel
- Department of Pathology, Technical University of Munich, 81675, Munich, Germany.
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Abstract
RATIONALE Ectopic pheochromocytoma is a special type of pheochromocytoma which occurs outside the adrenal gland. The most common symptoms of ectopic pheochromocytoma are palpitations, headaches, profuse sweating, and hypertension. In clinical practice, diagnosis of ectopic pheochromocytoma remains difficult. PATIENT CONCERNS The patient was a 43-year-old female who was admitted to our hospital with the chief complaint of upper abdominal discomfort for 1 week. Computed tomography demonstrated a neoplasm in the head of pancreas. The patient also had history of hypertension and type-2 diabetes. DIAGNOSIS According to the postoperative pathological examination, the lesion was mainly composed of chromaffin cells. Immunohistochemical staining revealed that the tumor expressed chromogranin A, NSE, and synaptophysin. Based on these findings, this mass was diagnosed as benign ectopic pheochromocytoma (paraganglioma). INTERVENTIONS Surgical resection operation was carried out and the patient's blood pressure was monitored continuously. Vasopressor or anti-hypertensive drugs were used according to circumstances. OUTCOMES The patient recovered well and was discharged from hospital with normal blood pressure. LESSONS This report reminds us to pay close attention to the likelihood of ectopic pheochromocytoma and other low-incidence diseases. Physicians and imaging clinicians should explore all clinical possibilities to avoid missed diagnosis or misdiagnosis of ectopic pheochromocytoma and take effective treatment measures to maximize patient benefits.
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Baugh KA, Villafane N, Farinas C, Dhingra S, Silberfein EJ, Massarweh NN, Cao HT, Fisher WE, Van Buren G. Pancreatic Incidentalomas: A Management Algorithm for Identifying Ectopic Spleens. J Surg Res 2019; 236:144-152. [DOI: 10.1016/j.jss.2018.11.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/01/2018] [Accepted: 11/19/2018] [Indexed: 12/21/2022]
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Abstract
Ectopic pheochromocytoma (EP) is considered as pheochromocytoma located at extra-adrenal site. Surgical removal is believed to be the best choice for treatment of pheochromocytoma. We present a series EP resected by laparoscopic approach (LEP) and confirm its feasibility. We retrospectively reviewed clinical data of 4 patients underwent laparoscopic resection of LEP (periaortocaval EP, n = 1; retroperitoneal EP, n = 2; bladder EP, n = 1), which was collected and analyzed retrospectively in Zhejiang Provincial People's Hospital. The tumors were all successfully resected by laparoscopic approach, and there was no one conversed to open surgery or needing blood transfusion. Laparoscopic resection is a feasible and safe choice for EP.
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Affiliation(s)
- Hanhui Cai
- Department of Hepatobiliary, Pancreatic and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
- Department of Second Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuhua Zhang
- Department of Hepatobiliary, Pancreatic and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Zhiming Hu
- Department of Hepatobiliary, Pancreatic and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
- Address correspondence to: Dr. Zhiming Hu, Department of Hepatobiliary, Pancreatic and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China. E-mail:
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Chaaya G, Morales J, Castiglioni A, Subhani N, Asmar A. Paraganglioma of the Urinary Bladder: A Rare Cause of Hypertension and Urinary Tract Infections. Am J Med Sci 2017; 355:191-194. [PMID: 29406048 DOI: 10.1016/j.amjms.2017.03.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 01/28/2017] [Accepted: 03/21/2017] [Indexed: 02/07/2023]
Abstract
Pheochromocytoma is a neoplasm, which develops from cells of the chromaffin tissues that are derived from the ectodermic neural system and mostly situated within the adrenal medulla. Approximately 15% of pheochromocytoma cases arise from extra-adrenal chromaffin tissue. Pheochromocytoma of the bladder is rare and accounts for less than 0.06% of all bladder neoplasms and less than 1% of all pheochromocytomas. We report a case of a young woman who presented with uncontrolled hypertension, recurrent urinary tract infections and micturition attacks and was found to have a metastatic bladder paraganglioma. In addition, we provide a summary table of the clinical manifestations of paragangliomas based on anatomic locations.
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Affiliation(s)
- Gerard Chaaya
- University of Central Florida College of Medicine, Orlando, Florida
| | - Jorge Morales
- University of Central Florida College of Medicine, Orlando, Florida
| | - Analia Castiglioni
- University of Central Florida College of Medicine, Orlando, Florida; Orlando VA Medical Center, Orlando, Florida
| | - Noman Subhani
- University of Central Florida College of Medicine, Orlando, Florida; Osceola Regional Medical Center, Kissimmee, Florida
| | - Abdo Asmar
- University of Central Florida College of Medicine, Orlando, Florida; Orlando VA Medical Center, Orlando, Florida.
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