2026/01/01 by Anna Battistella, Marco Schiavo Lena, V. Andreasi +2 · 1 voice
Medicine · #Adrenal and Paraganglionic Tumors #Neuroendocrine Tumor Research Advances #Gastrointestinal Tumor Research and Treatment
paper · doi:10.1530/eo-25-0117
openalex publication_date 2026/01/01 · openalex created_date 2026/03/24 · openalex updated_date 2026/07/08
Ga-DOTATOC positron emission tomography/CT showed intense somatostatin receptor uptake confined to the mesenteric nodule, with no other lesions. Dedicated pan-colonoscopy was unremarkable and 24-h urinary 5-hydroxyindoleacetic acid was within normal limits. Preoperative diagnosis of nodal metastasis from an occult ileal neuroendocrine tumor was made, and laparoscopic surgery was undertaken. Meticulous bimanual palpation of the small bowel with transillumination did not reveal any primary lesions, while a 1 cm mesenteric mass was identified and excised. Histology revealed a solid tumor with Zellballen architecture with tumor cells positive for chromogranin A and GATA3, and negative stains for cytokeratin, CDX2, and serotonin, establishing the diagnosis of paraganglioma. This case highlights the importance of recognizing paraganglioma as a potential diagnostic mimic in solitary somatostatin receptor-avid mesenteric nodules to prevent unnecessary investigations and guide appropriate surgical management. Learning points: Primary mesenteric paragangliomas should be considered in the differential diagnosis of solitary, hypervascularized mesenteric masses.A solitary SSTR-avid mesenteric nodule in an asymptomatic, biochemically silent patient does not necessarily imply nodal metastasis from an occult small intestinal neuroendocrine tumor.Considering alternative diagnoses may avoid unnecessary endoscopic, radiological, and surgical investigations for an intestinal primary lesion.Definitive diagnosis and risk stratification rely on histopathology and immunohistochemistry, including epithelial markers, GATA3, and SDHB.Awareness of mesenteric paraganglioma as a diagnostic mimic can prevent overtreatment and guide appropriate surgical management.