Luo SZ, Liu JR, Liu TQ, Chen Q. Functional paraganglioma of the pancreatic head: A case report and review of literature. World J Gastrointest Surg 2025; 17(7): 105833 [DOI: 10.4240/wjgs.v17.i7.105833]
Corresponding Author of This Article
Tian-Qi Liu, MD, Department of General Surgery, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Heti Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China. gxljrqt@163.com
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/
Shang-Zheng Luo, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
Shang-Zheng Luo, Department of General Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Jin-Rui Liu, Department of Sports Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
Tian-Qi Liu, Department of General Surgery, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Qing Chen, Department of Scientific Research and Education, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Co-corresponding authors: Tian-Qi Liu and Qing Chen.
Author contributions: Luo SZ developed the concept and design, obtained the data, analyzed and interpreted the data and drafted the article; Liu JR analyzed and interpreted the data; Liu TQ contributed to the critical revision of the article for important intellectual content; Chen Q revised the content of the article as well as the standardized terminology; Liu TQ and Chen Q contributed equally as co-corresponding authors; and all authors approved the final manuscript to be published.
Supported by the Guangxi Medical and Health Care Appropriate Technology Development and Popularization and Application Project, No. S2023034.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tian-Qi Liu, MD, Department of General Surgery, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Heti Road, Qingxiu District, Nanning 530021, Guangxi Zhuang Autonomous Region, China. gxljrqt@163.com
Received: February 8, 2025 Revised: April 9, 2025 Accepted: May 30, 2025 Published online: July 27, 2025 Processing time: 165 Days and 23 Hours
Abstract
BACKGROUND
Pheochromocytoma and paraganglioma (PGL) are a rare group of neuroendocrine neoplasms with characteristic genetic diversity and catecholamine secretion patterns. They arise from non-neuronal and non-epithelial neuroendocrine cells of the paraganglia, and have the highest rate of heritability among all tumors.
CASE SUMMARY
A 76-year-old woman presented with the complaint of dizziness that had persisted for one week. She had a 30-year history of hypertension. Despite long-term use of antihypertensive drugs, her blood pressure was not effectively controlled. A tumor was subsequently found in the head of the pancreas by computed tomography and magnetic resonance imaging and she was initially diagnosed with an aneurysm. On December 21, 2021, she underwent resection of the retroperitoneal tumor and pancreatic repair surgery. However, after postoperative pathological analysis and immunohistochemistry, the diagnosis was revised to PGL. After two years and eight months of follow-up, the tumor did not recur or metastasize, and her blood pressure returned to normal without taking antihypertensive drugs.
CONCLUSION
The possibility of PGL should be considered when a tumor is identified and patients have catecholamine secretion related symptoms that are difficult to control with medications.
Core Tip: We report a rare case of paraganglioma (PGL) of the pancreatic head in a patient with a history of persistent hypertension. Due to atypical clinical presentation and imaging features, it is difficult to differentiate PGL from peripancreatic tumor. PGL may induce persistent clinical symptoms related to hypertension without causing other clinical manifestations that draw the attention of from patients over a long period. In order to improve the diagnostic accuracy of pancreatic PGL, the combination of tests for specific biomarkers (metanephrines/normetanephrines is recommended) and imaging examinations based on individual circumstances is highly recommended. Surgery is still recommended as the mainstay of treatment.
