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Pancreatic Paraganglioma: A Case Report.
Sumant Tumuluru1, Vincent Mellnick1, Maria Doyle2
1Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri.
Case Reports in Pancreatic Cancer
|January 12, 2019
Summary
Pancreatic paragangliomas are rare tumors incidentally found on imaging. Aggressive surgical removal is crucial for disease-free survival in these typically nonfunctional neoplasms.
Area of Science:
- Endocrinology
- Surgical Oncology
- Radiology
Background:
- Paragangliomas are neuroendocrine tumors originating from extra-adrenal paraganglia.
- Pancreatic paragangliomas are exceptionally rare, with fewer than 20 reported cases.
- These tumors are often nonfunctional and typically affect individuals in their fourth to fifth decades.
Observation:
- A 62-year-old woman presented with an incidentally discovered pancreatic mass during evaluation for an unrelated condition.
- Endoscopic ultrasound-guided fine needle aspirations revealed atypical epithelial cells.
- Serial CT scans showed avid, homogeneous enhancement and mild interval growth over 5 years.
Findings:
- The pancreatic mass was diagnosed as a paraganglioma post-operatively via laparoscopic distal pancreatectomy and splenectomy.
- The patient experienced a pancreatic duct leak requiring intervention but recovered well.
- Post-surgical imaging revealed no evidence of disease recurrence.
Implications:
- Pancreatic paragangliomas are often incidentally detected and characterized by avid enhancement on CT/MRI.
- Complete surgical resection is essential for optimal outcomes and disease-free survival.
- Histological features are consistent with paragangliomas found elsewhere in the body.
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