Table 1.
Literature review (2000–2022) of abdominal extra-adrenal paragangliomas diagnosed with FNA or FNB.
| First Author, Year | Gender, Age | Location | Diameter (Radiology) | Clinical Presentation | Biopsy Type | Preoperative Diagnosis | Immunochemistry on FNA/FNB Material | Surgery Performed | Follow-Up |
|---|---|---|---|---|---|---|---|---|---|
| Radulovic, 2022 [19] | F, 48 | Peripancreatic (Tail) | 35 mm (EUS) | Incidental mass; diarrhea and metrorrhagia | EUS-FNA | PPGL | Chr (+), Syn (+), GATA-3 (+), S100 (+), Ker (−), Inhibin (−), PAX8 (−), WT-1 (−), Ki-67 (<3%) |
Yes | No alterations found in subsequent genetic testing |
| Lanke, 2021 [5] | F, 73 | Peripancreatic (Head) |
19 mm (EUS) | Asymptomatic, incidental mass; metanephrine levels normal | EUS-FNA | PPGL | Chr (+), Syn (+), GATA-3 (+), Ker (−), Ki-67 (<1%) |
No | Alive, no recurrence (12 mo) |
| Thakur, 2021 [20] | M, 58 | Peripancreatic (Head and uncinate process) | 78 mm (EUS) | Asymptomatic, incidental mass; metanephrine levels normal | EUS-FNA | PPGL | Chr (+), Syn (+), GATA-3 (+), Ker (−) |
N/A | Under MIGB therapy, to be followed by surgery |
| Naito, 2021 [21] | F, 61 | Peripancreatic (Head/greater omentum) | 21 mm (CT) | Asymptomatic, incidental mass | EUS-FNA | NET | Chr (+), Syn (+), CD56 (+) |
Yes | Alive, no recurrence (6 mo) |
| Abbasi, 2020 [22] | F, 61 | Peripancreatic (Head) | 64 mm (EUS) | Asymptomatic, incidental mass | EUS-FNA | PanNET | Chr (+), Syn (+) | Yes | Alive, no recurrence (12 mo) |
| Yang, 2019 [23] | F, 67 | Peripancreatic (Head) | 50 mm (CT) | Abdominal pain, weight loss, nausea, vomiting | EUS-FNA | PPGL | Chr (+), Syn (+), CD56 (+), Ker (−), Ki-67 (<1%) |
No | N/A |
| Nguyen, 2018 [24] | F, 70 | Peripancreatic (Tail) |
58 mm (EUS) | Constipation, satiety | EUS-FNA | Suggestive of PPGL | Chr (+), Syn (+), GATA-3 (+), S100 (+), Ker (−), ER (−), CDX2 (−) |
Yes | N/A |
| Fite, 2018 [14] | M, 55 | Retroperitoneal | 97 mm | Discomfort | FNA | Consistent with PPGL | N/A | Yes | Recurrence after 9 years (same location) |
| Fite, 2018 [14] | M, 35 | Retroperitoneal | 83 mm | na | FNA | PPGL | N/A | Yes | Widespread bone and lung metastatic lesions at 5-year follow-up |
| Fite, 2018 [14] | M, 40 | Peripancreatic | 51 mm | Pain and hematuria; plasma metanephrine levels high | FNA | Suggestive of PanNET | N/A | Yes | Alive, no recurrence |
| Fite, 2018 [14] | F, 23 | Peripancreatic | 70 mm | Tachycardia; plasma chromogranin A levels high | FNA | NET | N/A | Yes | Alive, no recurrence |
| Zeng, 2017 [25] | F, 58 | Peripancreatic (Head) | 65 mm (MRI) | Abdominal pain | EUS-FNA | PPGL vs. PanNET | Chr (+), Syn (+), CD117 (−) |
Yes | N/A |
| Zeng, 2017 [25] | F, 53 | Peripancreatic | 25 mm (CT) | Pelvic pain | EUS-FNA | NET | Chr (+), Syn (+) | Yes | N/A |
| Tumuluru, 2016 [26] | F, 62 | Peripancreatic (Body) | 32 mm (EUS) | Asymptomatic; incidental mass | EUS-FNA | Atypical epithelial cells | N/A | Yes | Alive, no recurrence (18 mo) |
| Zhang, 2014 [18] | F, 50 | Widespread (pancreatic head; multiple liver lesions) | 60 mm (CT) for the peripancreatic lesion | Headache, palpitation, sweating, hypertension | FNA | Suggestive of PPGL | Chr (+), Syn (+) | Yes | Died (48 mo after diagnosis) |
| Handa, 2014 [27] | M, 32 | Paraaortic | N/A | Headache | FNA under US guidance | PPGL | N/A | N/A | N/A |
| Handa, 2014 [27] | F, 50 | Paraaortic | N/A | Abdominal mass | FNA under US guidance | PPGL | N/A | N/A | N/A |
| Moslemi, 2012 [15] | F, 55 | Perirenal (Intraperitoneal) | 150 mm (CT) | Abdominal pain, anorexia, weight loss | FNA under US guidance | Undifferentiated carcinoma | N/A | Yes | Alive, no recurrence (12 mo) |
| Ganc, 2012 [28] | F, 37 | Peripancreatic (Head) | 35 mm | Asymptomatic; incidental mass | EUS-FNA | NET | Chr (+), Syn (+) | Yes | N/A |
| Laforga, 2012 [29] | M, 85 | Paragastric | N/A | Abdominal pain | EUS-FNA | N/A | N/A | Yes | Alive, no recurrence (22 mo) |
| Singhi, 2011 [4] | F, 61 | Peripancreatic (Tail) | 140 mm | Abdominal pain | EUS-FNA | Pseudocyst | N/A | Yes | Alive, no recurrence (140 mo) |
| Singhi, 2011 [4] | F, 52 | Peripancreatic (Body) | 140 mm | Abdominal pain | EUS-FNA and FNB | PPGL | N/A | No | Widespread metastatic lesions, DOD (34 mo) |
| Singhi, 2011 [4] | F, 54 | Peripancreatic (Head) | 65 mm | Abdominal pain | EUS-FNA and FNB | PPGL | N/A | Yes | Alive, no recurrence (8 mo) |
| Singhi, 2011 [4] | M, 40 | Peripancreatic (Body) | 51 mm | Asymptomatic; incidental mass in radiology | EUS-FNA | PanNET | N/A | Yes | Alive, no recurrence (4 mo) |
| Singhi, 2011 [4] | F, 78 | Peripancreatic (Body) | 170 mm | Abdominal pain | EUS-FNA | Spindle cell neoplasm | N/A | Yes | Alive, no recurrence (2 mo) |
| Singhi, 2011 [4] | M, 44 | Peripancreatic (Head) | 55 mm | Asymptomatic; incidental mass | EUS-FNA and FNB | PPGL | N/A | Yes | Alive, no recurrence (2 mo) |
| Sangster, 2010 [30] | M, 50 | Peripancreatic (Head) | N/A | Abdominal pain; hypertension | FNA | Poorly differentiated carcinoma | N/A | No (a surgical biopsy was though performed, providing the final diagnosis) | Alive, no recurrence (37 mo) |
| Rangaswamy, 2010 [31] | M, 45 | Perirenal | 120 mm (CT) | Asymptomatic; incidental mass; hypertension (metanephrine levels high) | FNA under CT guidance | Suggestive of PPGL | N/A | Yes | N/A |
| Kubota, 2010 [16] | F, 58 | Paraduodenal | 70 mm (CT) | Asymptomatic; incidental mass; transient hypertension during the EUS-FNA procedure; metanephrine levels high | EUS-FNA | Suggestive of PPGL | N/A | Yes | N/A |
| Jiménez-Heffernan, 2006 [13] | F, 58 | Retroperitoneal | N/A | N/A | FNA | NET | Chr (+) | Yes | N/A |
| Jiménez-Heffernan, 2006 [13] | M, 47 | Retroperitoneal | N/A | N/A | FNA | NET | NP | Yes | N/A |
| Akdamar, 2004 [17] | F, 62 | Paraduodenal | 66 mm (EUS) | Abdominal pain; transient hypertension during the EUS-FNA procedure | EUS-FNA | Suggestive of a neoplasm | N/A | Yes | N/A |
| Gong, 2003 [32] | F, 69 | Organ of Zuckerkandl | 50 mm (CT) | Asymptomatic; incidental mass | FNA under CT guidance | Anaplastic carcinoma of the pancreas | NP | Yes | N/A |
| Gong, 2003 [32] | F, 74 | Retroperitoneal soft tissue | N/A | Large abdominal mass | FNA under US guidance | Pancreatic adenocarcinoma | NP | Yes | Recurrent PPGL lesion in the liver (60 mo) |
| Absher, 2001 [33] | M, 52 | Retrocrunal, paracaval, and paraaortic lesions; also, bone (rib, vertebral) lesions | 70 mm (CT) | Chest wall and back pain | FNA and FNB | PPGL | Chr (+), vim (+), Ker (−), EMA (−), CEA (−), desmin (−) | N/A | Widespread metastatic bone lesions |
| Our case | F, 35 | Paraduodenal | 65 mm (EUS) | Asymptomatic; incidental mass | EUS-FNB | PPGL | Chr (+), Syn (+), CD56 (+) GATA-3 (+), S100(+), Ker (−), PAX8 (−), Melan A (−), DOG1 (−) |
Yes | Alive, no recurrence (10 mo) |
Note: The term “peripancreatic” is used to describe the location of a lesion found around and/or within the pancreas. Abbreviations: PPGL, pheochromocytoma and paraganglioma; NET; neuroendocrine tumor; PanNET; pancreatic neuroendocrine tumor; EUS, endoscopic ultrasound; Chr, chromogranin; Syn, synaptophysin; Ker, Keratin; N/A, information not available; NP; not performed; mo, months.