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Peripancreatic paraganglioma:Lesson from a round table

World Journal of Gastroenterology 2022年第21期28卷 2396-2402页

作者： Federica Petrelli Geri Fratini Andrea Sbrozzi-Vanni Andrea Giusti Raffele Manta Claudio Vignali Gabriella Nesi Andrea Amorosi Andrea Cavazzana Marco Arganini Maria Raffaella Ambrosio Pathology Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Surgery Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Endoscopic Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Endoscopic Unit Santa Maria Misericordia HospitalPerugia 06122Italy Interventional Radiology Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Department of Health Sciences University of FlorenceFlorence 50139Italy Pathology Unit UniversitàMagna GraeciaCatanzaro 88100Italy

We described the case of a peripancreatic paraganglioma(PGL)misdiagnosed as pancreatic *** exploration revealed an unremarkable pancreas and a large well-defined cystic mass originating at the mesocolon *** enucleation of the mass was performed,preserving the pancreatic ***,a diagnosis of PGL was ***,two previously unreported mutations,one affecting the KDR gene in exon 7 and another on the JAK3 gene in exon 4 were *** mutations are known to be *** and cytologic findings were blindly reviewed by an expert panel of clinicians,radiologists,and pathologists to identify possible causes of the *** major issue was lack of evidence of a cleavage plane from the pancreas at imaging,which prompted radiologists to establish an intraparenchymal *** blinded revision shifted the diagnosis towards an extrapancreatic lesion,as the pancreatic parenchyma showed no structural alterations and no dislocation of the Wirsung *** post,the identified biases were the emergency setting of the radiologic examination and the very thin mesocolon sheet,which hindered clear definition of the lesion *** endoscopic ultrasonography diagnosis was confirmed,emphasizing the intrinsic limit of this technique in detecting large ***,pathologic review favored a diagnosis of PGL due to the morphological features and immonohistochemical *** months after tumor excision,the patient is asymptomatic with no disease relapse evident by either radiology or laboratory *** report strongly highlights the difficulties in rendering an accurate preoperative diagnosis of PGL.

关键词： Peripancreatic paraganglioma Pancreatic neuroendocrine tumor Solid pseudopapillary neoplasm S100 succinate dehydrogenase subunit b gene and expression Fine needle biopsy

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