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(37): 6322-6331 [PMID: 34712035 DOI: 10.3748/wjg.v27.i37.6322]
Corresponding Author of This Article
Jeffrey H Lee, AGAF, FACG, FASGE, MD, Director, Professor, Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1466, Houston, TX 77030, United States. jefflee@mdanderson.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 7, 2021; 27(37): 6322-6331 Published online Oct 7, 2021. doi: 10.3748/wjg.v27.i37.6322
Pancreatic paraganglioma diagnosed by endoscopic ultrasound-guided fine needle aspiration: A case report and review of literature
Gandhi Lanke, John M Stewart, Jeffrey H Lee
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
Author contributions: Lanke G composed and drafted the paper; Stewart JM provided path images, revised, and edited the draft; Lee JH conceptualized, designed, revised, and edited the draft.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None of the authors have any potential conflicts (financial, professional, or personal) that are relevant to the manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jeffrey H Lee, AGAF, FACG, FASGE, MD, Director, Professor, Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1466, Houston, TX 77030, United States. jefflee@mdanderson.org
Received: April 6, 2021 Peer-review started: April 6, 2021 First decision: June 17, 2021 Revised: June 28, 2021 Accepted: September 3, 2021 Article in press: September 3, 2021 Published online: October 7, 2021 Processing time: 175 Days and 13.2 Hours
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.
Core Tip: The morphologic overlap between pancreatic paraganglioma and neuroendocrine tumor is significant. An accurate diagnosis by endoscopic ultrasound-guided fine needle aspiration requires firstly that the possibility of paraganglioma is considered and secondly that a cell block is available for immunohistochemical stains. A patient-centered approach supported by a multidisciplinary team of radiologists, advanced endoscopists, endocrinologists, pathologists, oncologists, and surgeons is paramount in the management of pancreatic paraganglioma.
