Paraganglioma of the hepatic duct: a personal commentary.

To the Editor: In 1980, we reported a case of paraganglioma of the hepatic duct in a 37-year-old man. (1) At that time, we claimed that our case was the first such report in the English literature. The acceptance and subsequent publication of this case report was not easy. We received six rejections from various journals, such as the Archives of Pathology, Human Pathology, Journal of Clinical Pathology, and the American Journal of Gastroenterology. We understood that our claim of "the first report in the English literature" might have been a cause for some of those rejections. Finally, we sent the article to the Southern Medical Journal. Dr. John B. Thomison, the editor (himself a pathologist) accepted our article for publication.

Many years later, one of the authors received a telephone call from one of the editors revising the Armed Forces Institute of Pathology (AFIP) Fascicle 27 on the tumors of the gallbladder, extrahepatic bile ducts, and ampulla of Vater. He told me that his literature search had yielded a single report of a paraganglioma of the hepatic duct published in the Southern Medical Journal. (1) He wanted to review the microscopic slides and the electron microscopic pictures of the case, which were promptly sent to him. The AFIP Fascicle 27 published in 2000 describes our case with a single reference to our article published in 1980 in the Southern Medical Journal. (2)

The paraganglioma of the biliary tract remains a rare tumor in man. Since our first report in the Southern Medical Journal in 1980, (1) only three additional cases have been published in the English literature. One case of paraganglioma occurred in the common hepatic duct, (3) and the other two in the bile duct. (2,4) A review of the literature by the authors of these reports did not disclose any reported case before 1980.

Deba P. Sarma, MD

Department of Pathology

Creighton University Medical School

Omaha, NE

References

1. Sarma DP, Rodriguez FH Jr. Hoffmann EO. Paraganglioma of the hepatic duct. South Med J 1980;73:1677-1678.

2. Albores-Saavedra J. Henson DE, Klimstra DS. Tumors of the gallbladder, extrahepatic bile ducts, and ampulla of Vater. In: Atlas of Tumor Pathology, Fascicle 27. Third Series. Washington, DC, Armed Forces Institute of Pathology, 2000, pp 221-222, 226.

3. Hitanant S. Sriumpai S, Na-songkla S, et al. Paraganglioma of the common hepatic duct. Am J Gastroenterol 1984;79:485-488.

4. Caceres M. Mosquera LF, Shih JA, et al. Paraganglioma of the bile duct. South Med J 2001;94:515-518.