Harries K, Nunn T, Shah V, Richards D, Manson J McK
Departments of Upper Gastrointestinal Surgery, Radiology and Pathology, Singleton Hospital, Swansea, UK.
Dis Esophagus. 2004;17(2):191-5. doi: 10.1111/j.1442-2050.2004.00386.x.
Paraganglioma and the variant gangliocytic paraganglioma are rare gastrointestinal tumors. We present the first reported case of an esophageal paraganglioma and a review of the literature. From this review it seems that these tumors can occur at any age and usually present with acute or chronic bleeding with or without abdominal pain. The majority of reported cases originated in the foregut, most commonly the second part of the duodenum. Macroscopically the tumor may be pedunculated, sessile or ulcerated and have been described up to 10 cm in size. There are no reported cases of gut paragangliomas shown to be producing clinically significant amounts of catecholamines. The majority of reported tumors have been benign, only 7% malignant at presentation and all with lymph node metastases. One case developed bone metastases 3 years after excision and another recurred locally. There has been no benefit seen from radiotherapy or chemotherapy to date and it is recommended that all of these tumors are widely excised together with a lymph node resection if possible.
副神经节瘤和变异型神经节细胞性副神经节瘤是罕见的胃肠道肿瘤。我们报告首例食管副神经节瘤病例并对文献进行综述。从该综述来看,这些肿瘤可发生于任何年龄,通常表现为急性或慢性出血,伴或不伴有腹痛。大多数报道病例起源于前肠,最常见于十二指肠第二部。宏观上,肿瘤可为带蒂、无蒂或溃疡型,大小可达10厘米。尚无肠道副神经节瘤产生具有临床意义的儿茶酚胺量的报道。大多数报道的肿瘤为良性,仅7%在初诊时为恶性,且均有淋巴结转移。1例在切除后3年发生骨转移,另1例局部复发。迄今为止,放疗或化疗未见益处,建议所有这些肿瘤尽可能连同淋巴结切除术一起广泛切除。