Paraganglioma of the duodenum: a case report.

Paraganglioma of the duodenum is a tumor which typically occurs in the ampullary region and which has been regarded as benign. This patient, as well as most of the 25 similar cases previously described, presented with upper gastrointestinal bleeding. Diagnosis may be elusive, particularly when a Billroth II anastomosis has been done previously. Careful identification of the ampulla is mandatory to ensure safe excision of the tumor. The possibility of multicentricity in these tumors heightens the necessity of distinguishing them from ampullary carcinoma at operation.