同時罹患壺腹區周邊神經節細胞副神經節細胞瘤和遠端總膽管癌：一例罕見病例報告及文獻回顧

Synchronous Double Tumor of Periampullary Gangliocytic Paraganglioma and Distal Common Bile Duct Cancer: a Report of a Rare Case and Literature Review

神經節細胞副神經節細胞瘤是一種罕見腫瘤，此疾病由病理特徵來診斷，有三種不同的細胞型態構成神經節細胞副神經節細胞瘤，包括神經內分泌細胞、梭狀細胞合併許旺氏分化及神經節細胞。此疾病的臨床表現多樣，一般而言，此為良性疾病。在此我們報告一個七十五歲的男性病人因腹脹和疲倦而入院，經檢查發現有十二指腸腫瘤及總膽管腫瘤，病人接受胰臟及十二指腸切除術，病理診斷為神經節細胞副神經節細胞瘤及總膽管癌。經過三年腹部超音波及電腦斷層的追蹤，沒有復發的跡象。

Gangliocytic paraganglioma (GP) is a rare tumor. It is diagnosed according to its patho-logical characteristics. GP consists of three cell types: neuroendocrine cells, spindle-shaped cells with Schwannian differentiation, and ganglion cells. The clinical presentations vary among patients. In general, GP is a benign disease. We report a 75-year-old man with a com-mon bile duct tumor and duodenal tumor; the clinical presentations were abdominal fullness and general malaise. The patient underwent the Whipple procedure and common bile duct adenocarcinoma and GP were diagnosed. There is no evidence of recurrence after 3-year fol-low-up.