Abstract | INTRODUCTION: PRESENTATION OF CASE: A 50 year-old male presented with melena and hemoglobin concentration of 4.6g/dl. Esophagogastroduodenoscopy demonstrated a submucosal mass in the third portion of the duodenum with no active bleeding. CT scan identified no regional lymphadenopathy or distant metastasis. The tumor was resected through a longitudinal duodenotomy with negative margins. DISCUSSION: Endoscopic resection of duodenal gangliocytic paraganglioma appears to be safe and effective when tumor may be removed in its entirety by this method. If the tumor is not suspended by a stalk or there is suspicion for regional lymph node disease then surgical management is preferred. Radiation oncologists at high volume centers have endorsed utilization of adjuvant radiotherapy to the postsurgical bed in cases involving lymph node metastasis. Utilization of chemotherapy for management of this disease has not been reported. CONCLUSION: Localized duodenal gangliocytic paragangliomas are best managed by resection with negative margins. In cases in which the tumor is resected with negative margins, it appears to be safe to embark on a course of surveillance and forego adjuvant therapy.
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Authors | Tyler J Loftus, Jesse L Kresak, David H Gonzalo, George A Sarosi Jr, Kevin E Behrns |
Journal | International journal of surgery case reports
(Int J Surg Case Rep)
Vol. 8C
Pg. 5-8
( 2015)
ISSN: 2210-2612 [Print] Netherlands |
PMID | 25600615
(Publication Type: Journal Article)
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Copyright | Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved. |