Extraluminal Duodenal Gangliocytic Paraganglioma Presenting with Intractable Back Pain in a Patient with End-Stage Renal Disease
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Gangliocytic paragangliomas (GP) are rare neuroendocrine tumors (NET) defined by their triphasic histological features containing epithelioid, spindle, and ganglion-like cells . While GPs are nonfunctional benign NETs with a favorable prognosis , preoperative diagnosis and surgical planning remain challenging as they are often misdiagnosed for other more aggressive NETs . GPs are most commonly located in the 2nd portion of the duodenum, although there are reports of GPs found in the respiratory system, spinal cord, esophagus, pancreas, and appendix [1, 2]. GPs arising in the gastrointestinal tract are typically seen on endoscopy extending intraluminally. To our knowledge, this is the first case report of a large GP originating from the duodenum but completely invisible on endoscopy and extending into the retroperitoneum.
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