Gangliocytic paraganglioma of the duodenum: Report of a case with immunocytochemical and ultrastructural investigation

A case of gangliocytic paraganglioma is reported in a 70-year-old female presenting as a polypoid tumor of the second portion of the duodenum. Immunohistochemical and ultrastructural features of the tumor indicate that gangliocytic paraganglioma of the duodenum (GPD) represents an unique tumor originating from the neuroectodermal derivative exhibiting dual phenotypic expression toward paraganglionic and epithelial (neuroendocrine) cells. These findings correlate well with the literature and it is further suggested that GPD belongs to the histopathologic spectrum of tumors derived from the neural crest. The findings offer a plausible explanation for histogenetic genetic possibilities of the occurrence of pure epithelial tumors (i.e., carcinoid-like tumors) in the paraganglionic systems. The patient remains with no evidence of disease 4 years following a simple polypectomy.