Duodenal Ganglioneuroma: A Rare Tumor Causing Upper Gastrointestinal Bleed

Overview

Journal Surg J (N Y)

Specialty General Surgery

Date 2021 Sep 20

PMID 34541318

Authors

Arkadeep Dhali

Sukanta Ray

Gopal Krishna Dhali

Ranajoy Ghosh

Avik Sarkar

Affiliations

Soon will be listed here.

Abstract

Neuroblastic tumors (NTs) include neuroblastoma, ganglioneuroblastoma, and ganglioneuroma (GN). They are very rare in adults. The Surveillance, Epidemiology, and End Results identified 144 patients ≥20 years old at diagnosis (6.1%) from 1973 to 2002. GNs account for 14% of all localized NT. Since 1957, a total of four cases of GN of the duodenum have been reported. We report a novel case of GN of the periampullary region in the duodenum in a 41-year-old man presenting with chronic upper gastrointestinal bleed. Given the rarity of GNs in this age group and the nonspecificity of radiological features, this diagnosis is often missed until histopathology is done. This may negatively affect the prognosis of an otherwise well-prognosticated disease.

References

Esiashvili N, Goodman M, Ward K, Marcus Jr R, Johnstone P . Neuroblastoma in adults: Incidence and survival analysis based on SEER data. Pediatr Blood Cancer. 2006; 49(1):41-6. DOI: 10.1002/pbc.20859. View

Goldman R . Ganglioneuroma of the duodenum. Relationship to nonchromaffin paraganglioma of the duodenum. Am J Surg. 1968; 115(5):716-9. DOI: 10.1016/0002-9610(68)90109-8. View

Dhali A, Ray S, Ghosh R, Sarkar A, Dhali G . Massive Upper Gastrointestinal Hemorrhage in Brunner's Gland Hamartoma of Duodenum. Cureus. 2021; 13(6):e15875. PMC: 8312786. DOI: 10.7759/cureus.15875. View

Witkiewicz A, Galler A, Yeo C, Gross S . Gangliocytic paraganglioma: case report and review of the literature. J Gastrointest Surg. 2007; 11(10):1351-4. DOI: 10.1007/s11605-007-0217-9. View

Ljungberg O, Jarnerot G, Rolny P, WICKBOM G . Human pancreatic polypeptide (HPP) immunoreactivity in an infiltrating endocrine tumour of the papilla of Vater with unusual morphology. Virchows Arch A Pathol Anat Histol. 1981; 392(1):119-26. DOI: 10.1007/BF00430555. View

Hayes F, Green A, Rao B . Clinical manifestations of ganglioneuroma. Cancer. 1989; 63(6):1211-4. DOI: 10.1002/1097-0142(19890315)63:6<1211::aid-cncr2820630628>3.0.co;2-1. View

Kaatsch P . Epidemiology of childhood cancer. Cancer Treat Rev. 2010; 36(4):277-85. DOI: 10.1016/j.ctrv.2010.02.003. View

GEMER M, FEUCHTWANGER M . Ganglioneuroma of the duodenum. Gastroenterology. 1966; 51(5):689-93. View

Decarolis B, Simon T, Krug B, Leuschner I, Vokuhl C, Kaatsch P . Treatment and outcome of Ganglioneuroma and Ganglioneuroblastoma intermixed. BMC Cancer. 2016; 16:542. PMC: 4964292. DOI: 10.1186/s12885-016-2513-9. View

10.

Mosse Y, Deyell R, Berthold F, Nagakawara A, Ambros P, Monclair T . Neuroblastoma in older children, adolescents and young adults: a report from the International Neuroblastoma Risk Group project. Pediatr Blood Cancer. 2013; 61(4):627-35. DOI: 10.1002/pbc.24777. View

11.

Buchler M, Malfertheiner P, Baczako K, Krautzberger W, Beger H . A metastatic endocrine-neurogenic tumor of the ampulla of Vater with multiple endocrine immunoreaction--malignant paraganglioma?. Digestion. 1985; 31(1):54-9. DOI: 10.1159/000199178. View

12.

Jiang C, Wu C, Ng K, Chung M, Tan S . Ganglioneuroma of the duodenum. Report of a case and literature review. Dig Dis Sci. 1993; 38(8):1554-7. DOI: 10.1007/BF01308620. View

13.

Rogowitz E, Babiker H, Kanaan M, Millius R, Ringenberg Q, Bishop M . Neuroblastoma of the elderly, an oncologist's nightmare: case presentation, literature review and SEER database analysis. Exp Hematol Oncol. 2014; 3:20. PMC: 4112985. DOI: 10.1186/2162-3619-3-20. View

14.

De Bernardi B, Gambini C, Haupt R, Granata C, Rizzo A, Conte M . Retrospective study of childhood ganglioneuroma. J Clin Oncol. 2008; 26(10):1710-6. DOI: 10.1200/JCO.2006.08.8799. View

15.

Shimada H, Ambros I, Dehner L, Hata J, JOSHI V, Roald B . Terminology and morphologic criteria of neuroblastic tumors: recommendations by the International Neuroblastoma Pathology Committee. Cancer. 1999; 86(2):349-63. View

16.

Maris J . Recent advances in neuroblastoma. N Engl J Med. 2010; 362(23):2202-11. PMC: 3306838. DOI: 10.1056/NEJMra0804577. View

17.

Duhem-Tonnelle V, Vinchon M, Defachelles A, Cotten A, Dhellemmes P . Mature neuroblastic tumors with spinal cord compression: report of five pediatric cases. Childs Nerv Syst. 2005; 22(5):500-5. DOI: 10.1007/s00381-005-0009-z. View

18.

London W, Castleberry R, Matthay K, Look A, Seeger R, Shimada H . Evidence for an age cutoff greater than 365 days for neuroblastoma risk group stratification in the Children's Oncology Group. J Clin Oncol. 2005; 23(27):6459-65. DOI: 10.1200/JCO.2005.05.571. View

19.

Dhali A, Ray S, Dhali G, Ghosh R, Sarkar A . Refractory hypoglycaemia in a localised gastrointestinal stromal tumour: Case report. Int J Surg Case Rep. 2021; 83:106023. PMC: 8188391. DOI: 10.1016/j.ijscr.2021.106023. View

20.

DAHL E, WAUGH J, Dahlin D . Gastrointestinal ganglioneuromas; brief review with report of a duodenal ganglioneuroma. Am J Pathol. 1957; 33(5):953-65. PMC: 1934663. View