Pancreas-sparing tumor resection for peripancreatic paraganglioma: A case series of six patients

Abstract

Abstract Background Paragangliomas(PGLs) located around the pancreas are rare and challenging to diagnose preoperatively. Tumor resection with pancreatectomy is often performed for peripancreatic PGL. However, pancreas-sparing tumor resection can be indicated with an accurate preoperative diagnosis.Methods This case series included six patients with pathologically diagnosed peripancreatic PGL resected at the National Cancer Center Hospital East between 2002 and 2020. The clinical data of the patients were retrospectively collected from our medical records.Results Five of six patients were suspected of peripancreatic PGL on imaging studies due to the fat plane identified between the hypervascular tumor and pancreas, and subsequently diagnosed with PGL preoperatively based on elevated urinary catecholamine levels and/or metaiodobenzylguanidine scintigraphy results without tumor biopsy. All patients underwent pancreas-sparing tumor resection with negative surgical margins, and they did not develop postoperative complications related to potential damage to the pancreas.Conclusions A fat plane between the hypervascular tumor and pancreas on imaging studies and hormone levels are key findings for obtaining an accurate preoperative diagnosis of peripancreatic PGL, which can be managed with pancreas-sparing tumor resection.