Wang Wenchao, Qin Yunsheng, Zhang Huifang, Chen Kangjie, Liu Zhengtao, Zheng Shusen
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Pathology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Gland Surg. 2021 Apr;10(4):1523-1531. doi: 10.21037/gs-20-758.
Paraganglioma (PGL) is an uncommon tumor located in the head, neck and abdomen. The majority of the tumor is benign and the patient has no obvious clinical symptoms. However, PGL located in the pancreas is rather rare and tends to mimic Castleman's disease, pancreatic neuroendocrine tumors and pancreatic primary tumor. Herein, we reported a patient with PGL that occurred in the neck of the pancreas. A 75-year-old Chinese female presented to our hospital with a complaint of upper abdomen pain for two weeks and she had good past health. The laboratory findings and physical examination were all normal. Preoperative computed tomography (CT) and magnetic resonance imaging revealed a tumor located in the neck of the pancreas and a tentative diagnosis of Castleman's disease or PGL was made. We resected the tumor by laparoscopic surgery. Postoperative pathology and immunohistochemistry confirmed that the tumor was a PGL. The patient was recovered well after a postoperative follow-up of 6 months. PGL located in the neck of the pancreas is difficult to be diagnosed accurately and clinicians have difficulties in distinguishing PGL from Castleman's disease, pancreatic neuroendocrine tumors and pancreatic primary tumor. Fifteen cases were listed to show the characters of PGL located in the pancreas and we also presented the difference among PGL, Castleman's disease and pancreatic neuroendocrine tumor. We showed our experience of treating such a rare tumor hoping to help clinicians correctly diagnose and treat PGL.
副神经节瘤（PGL）是一种位于头、颈和腹部的罕见肿瘤。大多数肿瘤为良性，患者无明显临床症状。然而，位于胰腺的PGL相当罕见，且往往类似Castleman病、胰腺神经内分泌肿瘤和胰腺原发性肿瘤。在此，我们报告了1例发生于胰腺颈部的PGL患者。一名75岁中国女性因上腹部疼痛两周就诊于我院，既往健康状况良好。实验室检查结果和体格检查均正常。术前计算机断层扫描（CT）和磁共振成像显示胰腺颈部有一肿瘤，初步诊断为Castleman病或PGL。我们通过腹腔镜手术切除了肿瘤。术后病理及免疫组化证实该肿瘤为PGL。术后随访6个月，患者恢复良好。位于胰腺颈部的PGL难以准确诊断，临床医生在鉴别PGL与Castleman病、胰腺神经内分泌肿瘤及胰腺原发性肿瘤方面存在困难。列出15例病例以展示位于胰腺的PGL的特征，我们还阐述了PGL、Castleman病和胰腺神经内分泌肿瘤之间的差异。我们展示了治疗这种罕见肿瘤的经验，希望能帮助临床医生正确诊断和治疗PGL。
