A CASE OF A PARAGANGLIOMA ARISEN IN THE VICINITY OF THE PANCREAS HEAD WITH HEPATIC METASTASIS

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  • KUDO Shinji
    Department of Surgery, Ibaraki Prefectural Central Hospital
  • YOSHIMI Fuyo
    Department of Surgery, Ibaraki Prefectural Central Hospital
  • ASATO Yuji
    Department of Surgery, Ibaraki Prefectural Central Hospital
  • KATO Yojiro
    Department of Surgery, Kidney Center, Tokyo Women's Medical University
  • IMURA Joji
    Department of Pathology, Ibaraki Prefectural Central Hospital

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  • 膵頭部近傍に発生し肝転移を認めたｐａｒａｇａｎｇｌｉｏｍａの１例

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Abstract

A 46-year-old man was admitted to a hospital because of jaundice in July 2003, when a tumor 6cm in diameter was found in the vicinity of the pancreas head. The patient was considered not to be a candidate for surgery because of possible involvement of the portal vein. In August of this year the patient was referred to our hospital to ask for a second opinion. With close exploration after admission a submucosal tumor of the duodenum with portal invasion was diagnosed, and laparotomy was performed. During surgery, tumor invasion measuring about 3cm on the dorsal aspect of the portal vein was suggested, and thus pylorus preserving pancreatoduodenectomy with associated resection of portal vein was carried out. The histopathological diagnosis was paraganglioma. Following imaging diagnosis conducted thereafter, hepatic metastasis was suggested. Hepatic resection involving the liver S6 and S5 was performed in January 2004. The histopathological diagnosis was hepatic metastasis of paragamglioma. The patient has been free from recurrence, as of 22 months after the second operation.

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