Gangliocytic paraganglioma in the third portion of the duodenum

Abstract

Gangliocytic paraganglioma is a non-epithelial, neuroendocrine tumor that originates from the neural crest. In the majority of cases, it affects the second part of the duodenum, however it may occur in any of its parts and even originate in the proximal jejunum, the appendix and other less frequent places. Because of its location and high tendency to ulcerate, these lesions can appear as gastrointestinal bleeding, jaundice, obstruction and anemia, as in the case described herein. Also, many times they are found incidentally during endoscopy or autopsy. Gangliocytic paraganglioma is a benign tumor, with a favorable prognosis, but some cases of recurrence, lymphatic invasion and metastasis have been reported. Histologically gangliocytic paraganglioma is composed by various cell patterns which can be found by immunohistochemistry and in some cases its treatment consists of radical or local resection.