Pancreatic paraganglioma with multiple lymph node metastases found by spectral computed tomography: A case report and review of the literature

作者全名："Li, Ting; Yi, Rong-Qi; Xie, Gang; Wang, Dan-Ni; Ren, Yi-Tao; Li, Kang"

作者地址："[Li, Ting; Xie, Gang] North Sichuan Med Coll, Dept Med Imaging, Nanchong 637000, Sichuan, Peoples R China; [Yi, Rong-Qi; Li, Kang] Chongqing Gen Hosp, Dept Radiol, Chongqing 401147, Peoples R China; [Wang, Dan-Ni; Ren, Yi-Tao] Chongqing Med Univ, Dept Med Imaging, Chongqing 400016, Peoples R China; [Li, Kang] Chongqing Gen Hosp, Dept Radiol, 118 Xingguang Ave Liangjiang New Area, Chongqing 401147, Peoples R China"

通信作者："Li, K (通讯作者)，Chongqing Gen Hosp, Dept Radiol, 118 Xingguang Ave Liangjiang New Area, Chongqing 401147, Peoples R China."

来源：WORLD JOURNAL OF CLINICAL CASES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000885256200047

JCR分区：Q3

影响因子：1.1

年份：2022

卷号：10

期号：31

开始页：11638

结束页：11645

文献类型：Article

关键词：Spectral computed tomography; Pancreas; Paraganglioma; Lymph node metastasis; Case report

摘要："BACKGROUND Primary pancreatic paraganglioma is exceedingly rare. Most patients with pancreatic paraganglioma lack a typical clinical presentation, and the tumor is difficult to accurately differentiate from other pancreatic neuroendocrine tumors, making the misdiagnosis rate extremely high. Surgical excision is the primary treatment modality but is considered high risk. Because of its rich vascularity, the tumor easily bleeds during surgery, especially malignant paragangliomas invading large blood vessels. Thus, a thorough preoperative evaluation of the tumor is necessary. Here, we report a primary malignant pancreatic paraganglioma, the second such case in a young patient that was successfully resected surgically. CASE SUMMARY A 26-year-old female patient was admitted to the hospital with unexplained abdominal pain. Dual-layer spectral-detector computed tomography (DLCT) revealed a mixed density mass in the pancreatic body and tail. The patient was transferred to our hospital after previous failed surgical resection at other hospitals. The patient and her family strongly desired surgery. After a thorough preoperative evaluation and adequate preparation, a large mass with the greatest dimension of 8.0 cm was successfully resected. The final pathological diagnosis was malignant paraganglioma. The patient was discharged in good condition 2 wk postoperatively. CONCLUSION The rare malignant pancreatic paraganglioma reported here was difficult to diagnose preoperatively. Early filling of the draining vein may be a crucial diagnostic imaging feature. DLCT can provide more precise information for surgical resection through dual-energy imaging."

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