Endoscopic removal of gangliocytic paraganglioma of the major duodenal papilla

Background. Gangliocytic paraganglioma is an extremely rare gastrointestinal tumor that is misdiagnosed as a neuroendocrine tumor. Due to the tendency of these tumors to metastasize to regional lymph nodes and the liver, they must be removed. However, due to the fact that gangliocytic paraganglioma is a rare tumor and the diagnosis is often made only on the basis of a morphological study of a removed specimen, an exact algorithm of action does not exist today. Clinical case. A 36-year-old patient who had previously undergone endoscopic removal of a MDP tumor was treated at the Surgical Endoscopy Department of the Vishnevsky National Research Medical Center for Surgery in connection with a neoplasm of type IV MDP according to the endoscopic classification of MDP neoplasms. Results. In our observation, clinical success was achieved in the treatment of a patient with gangliocytic paraganglioma of the MDP, which at the preoperative stage was diagnosed as a MDP adenoma with low-grade dysplasia. Endoscopic surgery included removal of the tumor by papillectomy, as well as stenting of the gastrointestinal tract to prevent the development of post-manipulation pancreatitis. The radicality of endoscopic removal of such a rare and potentially malignant tumor of the MDP was achieved due to the exclusion of metastasis to regional lymph nodes and liver during a comprehensive diagnosis, as well as the correctly chosen treatment approach. Conclusion. The use of minimally invasive endoscopic technologies in the treatment of a patient with gangliocytic paraganglioma of the MDP allowed us to obtain a good clinical result and avoid highly traumatic surgical intervention.