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Pancreatic paraganglioma diagnosed by endoscopic ultrasound-guided fine needle aspiration: A case report and review of literature
Authors:Gandhi Lanke  John M Stewart  Jeffrey H Lee
Institution:Gandhi Lanke, Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, Lubbock, TX 79407, United StatesJohn M Stewart, Pathology-lab Medicine Division, MD Anderson Cancer Center, Houston, TX 77030, United StatesJeffrey H Lee, Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, Houston, TX 77030, United States
Abstract:BACKGROUNDPancreatic paragangliomas (PPGL) are rare benign neuroendocrine neoplasms but malignancy can occur. PPGL are often misdiagnosed as pancreatic neuroendocrine tumor or pancreatic adenocarcinoma.CASE SUMMARYWe 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.CONCLUSIONAccurate 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.
Keywords:Pancreatic paraganglioma  Endoscopic ultrasound-guided fine needle aspiration  Meta-iodobenzylguanidine scan  Metanephrines  GATA-3  Immunohistochemistry  Case report
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