Endoscopic Management of Duodenal Paraganglioma: A Rare Case with Successful Outcome

Gangliocytic paragangliomas (GPs) are rare, typically benign neuroendocrine tumors predominantly located in the second portion of the duodenum. Although benign, they may rarely metastasize to regional lymph nodes. Minimally invasive endoscopic resection is increasingly being adopted as an alternative to surgical excision in selected nonmetastatic cases. We report the case of a 38-year-old woman presenting with progressive dysphagia and weight loss. Endoscopic evaluation revealed a periampullary polypoidal mass with central ulceration. Histopathology confirmed a GP. Cross-sectional imaging excluded metastatic disease. The lesion was successfully resected en bloc via endoscopic ampullectomy, with negative margins. Postprocedure recovery was uneventful, and 24-month surveillance demonstrated a healed scar without recurrence. This case highlights the efficacy of endoscopic ampullectomy as a safe and curative treatment for selected cases of duodenal GP. Given the rarity of this tumor, accumulating such evidence is vital to optimize patient-specific treatment strategies.