1
|
Chakraborty U, Chakrabarti A, Bandyopadhyay M. Ganglioneuroma presenting as subpulmonic effusion-a differential to consider? Indian J Thorac Cardiovasc Surg 2023; 39:526-530. [PMID: 37609606 PMCID: PMC10441855 DOI: 10.1007/s12055-023-01522-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 08/24/2023] Open
Abstract
Ganglioneuroma is a benign, slow-growing neurogenic tumor arising from neural crest cells. It is extremely rare (1/1,000,000) and is located most commonly in the posterior mediastinum (41.5%), retroperitoneum (37.5%), and adrenal glands (21%). We present a case of a 62-year-old lady who had complaints of shortness of breath on exertion and dyspnea for the past 3 months. She had no other significant history. Computerised tomography (CT) scan of the thorax suggested left-sided loculated subpulmonic pleural effusion, 14 × 12 cm in dimension. She underwent assisted video-assisted thoracoscopic surgery (VATS) exploration of the thorax with debridement and drainage of subpulmonic collection that was abutting the diaphragm, along with release of trapped lung. Histopathological examination showed multiple ruptured cystic masses with nodules; microscopical evidences of Schwann cells, ganglion cells, and spindle cells-all these along with immunohistochemistry-revealed features consistent with ganglioneuroma. Postoperative recovery was uneventful, and the patient did not have any complaints or other limitations to daily life activities at 6 months' follow-up. Ganglioneuroma is essentially benign in nature, asymptomatic, and rare. A systematic review of the literature has shown that giant-sized ganglioneuromas (size more than 10 cm) have rarely been reported. Surgical excision and clearance is the treatment modality of choice. In our case, due to large size and difficulty in access and mobilisation of the mass adherent to the diaphragm, assisted VATS had to be performed. We increased the size of the utility port from 5 to 10 cm and used a rib retractor for better surgical negotiation. This could have been more challenging, as there have been incidences where ganglioneuromas have extended both into the thoracic and abdominal cavities and even involved vital organs and vessels. Regular follow-up is essential, as late recurrence and slow progression potential is a known complication.
Collapse
Affiliation(s)
- Unmesh Chakraborty
- Department of Cardiothoracic and Vascular Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | - Amitabha Chakrabarti
- Department of Thoracic and Vascular Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
- Department of CTVS, KPC Medical College, Kolkata, India
| | - Manujesh Bandyopadhyay
- Department of Thoracic and Vascular Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| |
Collapse
|
2
|
Shah D, Chaudhary SR, Khan S, Mallik S. Overreliance on Radiological Findings Leading to Misdiagnosed Giant Retroperitoneal Ganglioneuroma: A Case Report and Literature Review. Cureus 2023; 15:e43914. [PMID: 37746449 PMCID: PMC10512760 DOI: 10.7759/cureus.43914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Ganglioneuroma is a rare, benign, well-differentiated neurogenic tumor most commonly located in the posterior mediastinum or retroperitoneum. Giant ganglioneuromas are even less common; this is only the 19th reported case in literature to date. We present a case of a giant retroperitoneal ganglioneuroma in a five-year-old child, which on imaging mimicked a mesenteric cyst and posed various challenges in its management. Histopathology later confirmed our misdiagnosis and revealed the tumor to be a ganglioneuroma. This unique case serves as a lesson for clinicians to not operate before receiving histopathological confirmation of their diagnosis.
Collapse
Affiliation(s)
| | | | - Shahin Khan
- General Surgery, Medical College Baroda, Vadodara, IND
| | | |
Collapse
|
3
|
Ling K, Xiaoping C, Xiaolu Y. A case of ganglioneuroma of the ureter and review of the literature. J Int Med Res 2022; 50:3000605221123671. [PMID: 36412222 PMCID: PMC9706062 DOI: 10.1177/03000605221123671] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/16/2022] [Indexed: 10/28/2023] Open
Abstract
Ganglioneuroma is a rare tumor originating from neural crest tissue of the sympathetic nervous system. We report on an approximately 55-year-old woman who was admitted to hospital with abdominal pain. Surgery revealed a tumor in her right ureter, which was pathologically confirmed as a ganglioneuroma. The patient underwent transabdominal total hysterectomy, bilateral adnexal resection, release of pelvic and intestinal adhesions, right ureteroscopy, right ureter retrograde intubation, right ureteral lesion excision, and ureteral anastomosis. A literature review indicated that most ganglioneuromas are benign tumors. Clinicians may consider total or subtotal tumor resection, depending on the tumor location and patient's condition. The patient's clinical condition may improve after surgery combined with periodic long-term follow-up.
Collapse
Affiliation(s)
- Ke Ling
- Department of Gynecology, Maoming
People’s Hospital, Maoming, China
| | - Chen Xiaoping
- Department of Pathology, Maoming
People’s Hospital, Maoming, China
| | - Yuan Xiaolu
- Department of Pathology, Maoming
People’s Hospital, Maoming, China
| |
Collapse
|
4
|
Pan J, Gu Y, Zhang F. One step excision combined with unilateral transforaminal intervertebral fusion via minimally invasive technique in the surgical treatment of spinal dumbbell-shaped tumors: A retrospective study with a minimum of 5 years’ follow-up. Front Surg 2022; 9:939505. [PMID: 36176344 PMCID: PMC9513348 DOI: 10.3389/fsurg.2022.939505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionSpinal dumbbell-shaped tumors are rare, usually benign tumors with intraspinal and paravertebral components connected through intervertebral foramen. Complete excision is often performed through traditional open surgery (TOS). The efficacy and long-term outcomes of minimally invasive surgery (MIS) have not been reported to date in resection of dumbbell-shaped spinal tumors.PurposeThe purpose was to evaluate the efficacy and long-term outcomes of minimally invasive resection combined with unilateral transforaminal intervertebral fusion (TIF) through comparing with TOS in the treatment of spinal dumbbell-shaped tumors.MethodsFifteen patients underwent MIS and 18 patients underwent TOS. Thoracic dumbbell-shaped tumors were directly exposed after removal of costotransverse joints, adjacent rib components, unilateral hemilamina, and facet joints. Lumbar dumbbell-shaped tumors were completely exposed after removal of transverse processes, unilateral hemilamina, and facet joints. Whether for minimally invasive resection or traditional open removal, dumbbell-shaped tumors were completely excised and unilateral TIF was performed to guarantee spinal stability. All patients were followed up for 5 years at least.ResultsThe mean length of surgical incision for two groups was 3.47 ± 0.37 vs. 6.49 ± 0.39 cm (p < 0.05). The average duration of the operation was 131.67 ± 26.90 vs. 144.17 ± 23.59 min (p > 0.05). The mean blood loss was 172.00 ± 48.79 vs. 285.83 ± 99.31 ml (p < 0.05). No blood transfusions were required in the two groups. The median length of hospitalization was 6 vs. 10 days (range: 5–8 vs. 7–14 days). The patients of two groups were monitored for an average of 65.93 ± 3.88 vs. 65.78 ± 3.56 months. At 5-year follow-up, all patients presented with normal neurological function (American Spinal Injury Association scale E). The Oswestry Disability Index in the MIS group decreased significantly more than the TOS group. No spondylolisthesis or spinal instability were found in the follow-up period. There was no recurrence of any spinal tumor 5 years after surgery.ConclusionsSpinal dumbbell-shaped tumors can be safely and effectively treated with minimally invasive resection combined with unilateral TIF. Compared with TOS, MIS offers a reduced length of surgical incision, blood loss, hospital stay, and postoperative pain. This surgical protocol might provide an alternative for the treatment of spinal dumbbell-shaped tumors.
Collapse
Affiliation(s)
- Jianfeng Pan
- Department of Orthopedic Surgery, Zhongshan Hospital Fudan University, Shanghai, China
- Department of Orthopedic Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yutong Gu
- Department of Orthopedic Surgery, Zhongshan Hospital Fudan University, Shanghai, China
- Shanghai Southwest Spine Surgery Center, Shanghai, China
- Correspondence: Yutong Gu
| | - Feng Zhang
- Shanghai Southwest Spine Surgery Center, Shanghai, China
- Joseph M. Still Burn and Reconstructive Center, Jackson, Mississippi, United States
| |
Collapse
|
5
|
Li S, Mao S, Ma Y, Zhu Z, Liu Z, Qian B, Sun X, Qiu Y. Scoliosis: an unusual clinical presentation of paraspinal ganglioneuroma. Spine Deform 2022; 10:1185-1195. [PMID: 35486319 DOI: 10.1007/s43390-022-00511-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/09/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To comprehensively present the clinical characteristics and treatment strategies in patients with scoliosis secondary to ganglioneuroma (S-GN). METHODS Six patients with S-GN treated surgically at a median age of 12 years were retrospectively reviewed and the median follow-up period was 6 years (4-14 years). The radiological features of GN and the associated scoliosis were evaluated. The surgical strategies and the corresponding outcomes were investigated. RESULTS All patients had a delayed diagnosis age of GN than scoliosis (12 vs. 9 years). GN was located at the posterior mediastinum in four patients (66.7%) and at retroperitoneum in two, respectively. Tumor occupancies were frequently detected on the X-ray films for four patients (66.7%), being uniformly on the convexity of the main curve. All patients complained of rapid progressive deformities during the growth period. Five patients (83.3%) received total tumor resections, one accepted partial resection. Deformity correction was implemented for all patients with an average rate of 66.4% on the main curve. No recurrence of the GN was detected for all totally tumor-resected patients at the latest follow-up. CONCLUSION S-GN is often misdiagnosed clinically. Paravertebral mass neighboring the apex of scoliosis can be meticulously detected from the X-ray films. Total tumor resection should be aggressively performed if possible. The deformity correction could be satisfactorily obtained and the risk of recurrence of the GN was relatively low.
Collapse
Affiliation(s)
- Song Li
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, Jiangsu Province, China
| | - Saihu Mao
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, Jiangsu Province, China.
| | - Yanyu Ma
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, Jiangsu Province, China
| | - Zezhang Zhu
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, Jiangsu Province, China
| | - Zhen Liu
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, Jiangsu Province, China
| | - Bangping Qian
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, Jiangsu Province, China
| | - Xu Sun
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, Jiangsu Province, China
| | - Yong Qiu
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, Jiangsu Province, China
| |
Collapse
|
6
|
Abstract
ABSTRACT Liposarcoma is a soft tissue tumor that commonly appears in the retroperitoneum and the extremities. Herein, we presented the imaging findings of a 68-year-old man with a paravertebral liposarcoma involving the adjacent vertebral bodies, appendices, and ribs. MRI revealed this mass located in the left side of T9 to T10 vertebral bodies. FDG PET/CT demonstrated the mass with intense FDG uptake. Finally, the pathological findings were consistent with a diagnosis of a primary paravertebral liposarcoma.
Collapse
Affiliation(s)
- Rang Wang
- From the Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | | | | |
Collapse
|
7
|
Koullouros M, Candler S, Smith C, Olakkengil S. Appendicitis and ganglioneuroma—an unusual co-existence. J Surg Case Rep 2022; 2022:rjab632. [PMID: 35079345 PMCID: PMC8784186 DOI: 10.1093/jscr/rjab632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 12/21/2021] [Indexed: 11/12/2022] Open
Abstract
Ganglioneuromas are benign, fully differentiated mature tumours related to neuronal tissues and usually seen in the gastrointestinal tract, retroperitoneum and mediastinum. The few cases of appendiceal ganglioneuromas that were previously described in the literature belong to the paediatric population and were associated with genetic mutations and syndromes. We present a unique case of an Aboriginal Australian adult with acute appendicitis and concurrent ganglioneuroma diagnosed using histopathology and immunohistochemistry using Neu-N, S100 and Sox-10. The patient had no history of any of the syndromes associated with ganglioneuromatosis and had no other relevant family history.
Collapse
Affiliation(s)
- Michalis Koullouros
- Correspondence address. Division of General Surgery, Port Augusta Hospital, Port Augusta, SA 5700 Australia. Tel: +61(08)86687500; E-mail:
| | | | | | | |
Collapse
|
8
|
Bin Gheshayan S, Alsadun D, Alharbi A, Alselaim NA. A Large Retroperitoneal Ganglioneuroma Presenting With an Abdominal Pain: A Case Report. Cureus 2021; 13:e20600. [PMID: 35103176 PMCID: PMC8778648 DOI: 10.7759/cureus.20600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 11/17/2022] Open
Abstract
Ganglioneuromas are rare benign neoplasms arising from neural crest tissue. They are a subtype of neurogenic tumors with ganglion cell origin. They are most commonly found in the retroperitoneum and posterior mediastinum. Most ganglioneuromas are found incidentally; most patients are asymptomatic, and it rarely causes symptoms, which are often induced by compression. Here we present a case of a 24-year-old lady, who was investigated for right lower abdominal pain and found to have a right retroperitoneal solid mass at the level of L5-S1, which was displacing the major vessels. The patient underwent open excision of the mass.
Collapse
|
9
|
Gaddipati R, Ma J, Dayawansa S, Shan Y, Huang JH, Garrett D, Qaiser R. Lumbar Ganglioneuroma Presenting With Scoliosis. Cureus 2021; 13:e16794. [PMID: 34513400 PMCID: PMC8405311 DOI: 10.7759/cureus.16794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 07/30/2021] [Indexed: 11/05/2022] Open
Abstract
Ganglioneuromas are rare, benign tumors arising from the sympathetic nervous system. The presentation of the tumor is variable and may be associated with scoliosis. Few reports of ganglioneuroma associated with scoliosis- exist and most involve the thoracic spine. Here, we present a 13-year-old female with scoliosis who was found to have a lumbar ganglioneuroma. The patient was treated with a subtotal resection and lumbar spinal fusion to correct her scoliosis in a single-stage operation. The patient's symptoms and scoliosis markedly improved following treatment without any complications. Additionally, we conducted an up-to-date literature review of ganglioneuromas associated with scoliosis that have been published in the last 20 years. We discuss variations in clinical presentation and surgical approach.
Collapse
Affiliation(s)
- Ravi Gaddipati
- Neurosurgery, Baylor Scott and White Medical Center - Temple, Temple, USA
| | - Joanna Ma
- Neurosurgery, Baylor Scott and White Medical Center - Temple, Temple, USA
| | - Samantha Dayawansa
- Neurosurgery, Baylor Scott and White Medical Center - Temple, Temple, USA
| | - Yuan Shan
- Pathology, Baylor Scott and White Medical Center - Temple, Temple, USA
| | - Jason H Huang
- Neurosurgery, Baylor Scott and White Medical Center - Temple, Temple, USA
| | - David Garrett
- Neurosurgery, Baylor Scott and White Medical Center - Temple, Temple, USA
| | - Rabia Qaiser
- Neurosurgery, Baylor Scott and White Medical Center - Temple, Temple, USA
| |
Collapse
|
10
|
Konbaz FS, Althunayan TA, Alzahrani MT, Altawayjri IA, Jawadi TA, Alhelal F, Abalkhail M, Aleissa S. Aggressive L3 vertebral hemangioma coexisting with adult thoracolumbar scoliosis: Case report. NORTH AMERICAN SPINE SOCIETY JOURNAL (NASSJ) 2021; 5:100040. [PMID: 35141607 PMCID: PMC8819962 DOI: 10.1016/j.xnsj.2020.100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 11/28/2022]
Abstract
Vertebral hemangiomas are benign vascular tumors that are commonly asymptomatic. A low percentage might become aggressive; however, they are not known to be associated with scoliosis. We present a case of a third lumbar vertebral lesion coexisting with a moderate thoracolumbar scoliosis. The patient's initial presentation was back pain with bilateral lower limb radiculopathy and neurogenic claudication. Diagnosis was established using CT and MRI, which showed classical findings of an aggressive vertebral hemangioma. The patient underwent Partial hemangioma excision and scoliosis correction, with satisfactory outcome at 1 year follow up.
Collapse
|
11
|
Non-Hodgkin Lymphoma With an Atypical Presentation: A Solitary Paravertebral Mass on FDG PET/CT. Clin Nucl Med 2020; 45:876-877. [PMID: 32604116 DOI: 10.1097/rlu.0000000000003155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
An 81-year-old woman was admitted with chest tightness and shortness of breath. Chest CT revealed massive pleural effusion on the right side as well as a right paravertebral soft tissue mass at the T8 to T10 level, showing intense enhancement. Her symptoms were successfully relieved by thoracentesis catheter drainage. On PET/CT, the paravertebral lesion demonstrated increased FDG uptake with an SUVmax of 7.5, indicating a suspected diagnosis of malignancy. Eventually, a CT-guided needle biopsy was performed, which confirmed the diagnosis of non-Hodgkin lymphoma.
Collapse
|
12
|
Kirchweger P, Wundsam HV, Fischer I, Rösch CS, Böhm G, Tsybrovskyy O, Alibegovic V, Függer R. Total resection of a giant retroperitoneal and mediastinal ganglioneuroma-case report and systematic review of the literature. World J Surg Oncol 2020; 18:248. [PMID: 32948207 PMCID: PMC7501651 DOI: 10.1186/s12957-020-02016-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ganglioneuromas (GNs) are extremely rare, slowly growing, benign tumors that can arise from Schwann cells, ganglion cells, and neuronal or fibrous tissues. Due to their origin from the sympathetic neural crest, they show neuroendocrine potential; however, most are reported to be hormonally inactive. Nevertheless, complete surgical removal is recommended for symptom control or for the prevention of potential malignant degeneration. CASE REPORT A 30-year-old female was referred to our oncologic center due to a giant retroperitoneal and mediastinal mass detected in computed tomography (CT) scans. The initial symptoms were transient nausea, diarrhea, and crampy abdominal pain. There was a positive family history including 5 first- and second-degree relatives. Presurgical biopsy revealed a benign ganglioneuroma. Total resection (TR) of a 35 × 25 × 25 cm, 2550-g tumor was obtained successfully via laparotomy combined with thoracotomy and partial incision of the diaphragm. Histopathological analysis confirmed the diagnosis. Surgically challenging aspects were the bilateral tumor invasion from the retroperitoneum into the mediastinum through the aortic hiatus with the need of a bilateral 2-cavity procedure, as well as the tumor-related displacement of the abdominal aorta, the mesenteric vessels, and the inferior vena cava. Due to their anatomic course through the tumor mass, the lumbar aortic vessels needed to be partially resected. Postoperative functioning was excellent without any sign of neurologic deficit. CONCLUSION Here, we present the largest case of a TR of a GN with retroperitoneal and mediastinal expansion. On review of the literature, this is the largest reported GN resected and was performed safely. Additionally, we present the first systematic literature review for large GN (> 10 cm) as well as for resected tumors growing from the abdominal cavity into the thoracic cavity.
Collapse
Affiliation(s)
- Patrick Kirchweger
- Department of General and Visceral Surgery, Ordensklinikum Linz – Barmherzige Schwestern, Linz, Austria
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Helwig Valentin Wundsam
- Department of General and Visceral Surgery, Ordensklinikum Linz – Barmherzige Schwestern, Linz, Austria
| | - Ines Fischer
- Department of General and Visceral Surgery, Ordensklinikum Linz – Barmherzige Schwestern, Linz, Austria
| | - Christiane Sophie Rösch
- Department of General, Visceral, Vascular, Thoracic and Transplantation Surgery, Ordensklinikum Linz – Elisabethinen, Linz, Austria
| | - Gernot Böhm
- Department of Radiology, Ordensklinikum Linz – Barmherzige Schwestern, Linz, Austria
| | - Oleksiy Tsybrovskyy
- Department of Pathology – Vinzenz Pathologieverbund, Ordensklinikum Linz, Linz, Austria
| | - Vedat Alibegovic
- Department of Pathology – Vinzenz Pathologieverbund, Ordensklinikum Linz, Linz, Austria
| | - Reinhold Függer
- Department of General and Visceral Surgery, Ordensklinikum Linz – Barmherzige Schwestern, Linz, Austria
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of General, Visceral, Vascular, Thoracic and Transplantation Surgery, Ordensklinikum Linz – Elisabethinen, Linz, Austria
| |
Collapse
|
13
|
Hussain MH, Iqbal Z, Mithani MS, Khan MN. Retroperitoneal Ganglioneuroma in a Patient Presenting With Vague Abdominal Pain. Cureus 2020; 12:e9133. [PMID: 32789073 PMCID: PMC7417092 DOI: 10.7759/cureus.9133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Ganglioneuroblastoma, neuroblastoma, and ganglioneuroma (GN) are the tumors that arise from the neural crest cells. Of these, GN has the most benign origin without metastatic potential. The most common sites of their origin are the posterior mediastinum and retroperitoneum. Although the imaging studies, including CT, are available to detect these tumors, the definitive diagnosis can only be made by histological examination. We present a case of a 40-year-old woman with a retroperitoneal GN causing longstanding, gradually increasing, uncontrolled abdominal pain due to its pressure effect on the pancreas, duodenum, and right kidney with the displacement of the inferior vena cava. An exploratory laparotomy was performed, and the mass was removed. Histopathology confirmed the benign nature of the mass (a GN). These tumors are rarely malignant and mostly asymptomatic. However, in our case, abdominal pain was affecting the patient’s life. After a discussion with the patient, an elective surgical procedure was performed, and the patient was symptom-free postoperatively and able to resume her regular routine.
Collapse
Affiliation(s)
| | - Zafar Iqbal
- Emergency Medicine, California Institute of Behavioural Neurosciences and Psychology, Fairfield, USA.,Emergency Department, The Kidney Center, Karachi, PAK
| | | | | |
Collapse
|
14
|
Elnady B, Abdelgawaad AS, Elkhayat H. Giant intrathoracic ganglioneuroma with scoliosis treated by one-stage posterior resection and scoliosis correction: a case report. SICOT J 2020; 6:12. [PMID: 32378512 PMCID: PMC7204781 DOI: 10.1051/sicotj/2020012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/17/2020] [Indexed: 11/16/2022] Open
Abstract
Spinal ganglioneuroma occurs mostly in the thoracic spine causing various manifestations including scoliosis that can be misdiagnosed as idiopathic scoliosis. Few reports exist in the literature on the diagnosis and management of scoliosis secondary to huge ganglioneuroma and usually staged treatment is preferred. In this report, we present a 17-year-old female patient presented with back pain, lower limbs numbness, spinal deformity, and shortness of breath. Plain X-rays showed a 50° right thoracic scoliotic curve. MRI and chest CT revealed a huge extra pulmonary mass shifting the mediastinum with intra spinal extension through the left neural foramina compressing the spinal cord. Percutaneous US guided needle biopsy confirmed the diagnosis of ganglioneuroma. One-stage posterior instrumented correction of scoliosis, spinal cord decompression, and excision of the whole mass from the mediastinum and the spine through posterior approach was done for the patient with smooth postoperative recovery. Chest CT scan was done 2 years after surgery and excluded any local recurrence.
Collapse
Affiliation(s)
- Belal Elnady
- Department of Orthopedic and Trauma Surgery, Assiut University Hospitals, 71111 Assiut, Egypt
| | - Ahmed Shawky Abdelgawaad
- Department of Orthopedic and Trauma Surgery, Assiut University Hospitals, 71111 Assiut, Egypt - Department of Spine Surgery, Helios Klinikum Erfurt, 99089 Erfurt, Germany
| | - Hussein Elkhayat
- Department of Cardiothoracic surgery, Assiut University Hospitals, 71111 Assiut, Egypt
| |
Collapse
|
15
|
Paravertebral lipomatous ganglioneuroma with intraspinal extension. Case report and literature review. Neurocirugia (Astur) 2019; 31:42-46. [PMID: 31129025 DOI: 10.1016/j.neucir.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 04/13/2019] [Accepted: 04/21/2019] [Indexed: 11/20/2022]
Abstract
Lipomatous ganglioneuromas are a rare variant of ganglioneuromas characterized by a mature adipocytic component admixed with a conventional ganglioneuroma component. We present the case of a 34 year old patient with a paravertebral right lesion L1-L4 with intraspinal extension and secondary neurological deficit, who underwent surgery in our hospital. The pathological anatomy showed a yellowish encapsulated neoplasm, which under microscopic evaluation showed areas of ganglioneuroma admixed with areas of mature fat. In the follow up, the patient was asymptomatic, had recovered paresis in the right lower extremity and in the last image control did not present data of lesion recurrence. Fewer than 10 cases of lipomatous ganglioneuromas have been reported in the literature, being this the first paravertebral case wih intraspinal extension and with neurological deficit, hence the interest of this work.
Collapse
|
16
|
Takebayashi K, Kohara K, Miura I, Yuzurihara M, Kubota M, Kawamata T. Lumbar Ganglioneuroma from the Paravertebral Body Presenting in Continuity Between Intradural and Extradural Spaces. World Neurosurg 2019; 128:289-294. [PMID: 31102769 DOI: 10.1016/j.wneu.2019.05.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Ganglioneuroma is a well-differentiated benign tumor that develops from the ganglion cells of the posterior mediastinum, retroperitoneum, cervical spine, and adrenal glands. The paravertebral body, in which the sympathetic trunk exists, is a common tumor site, and tumor sometimes invades the spinal canal through the intervertebral foramen. There have been no reports regarding tumors with intradural and extradural continuity. We report a paravertebral ganglioneuroma extending between the intradural and extradural spaces and its surgical treatment. CASE DESCRIPTION A 33-year-old man was admitted to the hospital with progressive left lower limb numbness. A dumbbell-type tumor progressing to the spinal canal via the left intervertebral foramen from the paravertebral body at L1-2 was detected, and intradural calcified lesions were found. Pathologic examination of a computed tomography-guided biopsy sample revealed a ganglioglioma. The extradural tumor was removed; however, the left lower limb pain gradually worsened. As complete block was observed on myelography, the intradural tumor was removed 8 months later. Intraoperative findings revealed that the intradural and extradural tumors were continuous through the L1 nerve root. CONCLUSIONS This is the first known reported case of paravertebral ganglioneuroma presenting in continuity between the intradural and extradural spaces.
Collapse
Affiliation(s)
- Kento Takebayashi
- Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan; Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
| | - Kotaro Kohara
- Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan; Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Isamu Miura
- Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan; Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Motoo Kubota
- Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan
| | - Takakazu Kawamata
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| |
Collapse
|
17
|
|
18
|
Wang X, Yang L, Shi M, Liu X, Liu Y, Wang J. Retroperitoneal ganglioneuroma combined with scoliosis: A case report and literature review. Medicine (Baltimore) 2018; 97:e12328. [PMID: 30212980 PMCID: PMC6156057 DOI: 10.1097/md.0000000000012328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Ganglioneuroma (GN) is a rare tumour arising from the sympathetic nervous system. GN is constantly asymptomatic, easily ignored and likely damages other organs during tumour progression. PATIENT CONCERNS The case report involved a 21-year-old girl who was admitted to a hospital because of a computed tomography result after her pregnancy examination showed retroperitoneal tumour and scoliosis. The scoliosis was considered as a tumour complication. DIAGNOSES The tumour was finally diagnosed as GN by pathological examination. INTERVENTIONS We carried out surgical treatment and performed a pathological examination on postoperative tumour specimens. OUTCOMES The patient was followed up for 19 months and did not show tumour recurrence. However, the condition of the scoliosis did not improve. LESSONS This paper reports a case of GN with scoliosis at the same time. GN is a benign tumour consisting of cells with a special origin. GN grows extensively and leads to different complications. Presently, pathological examination after an operation is the only approach to formulate an exact diagnosis. We should consider the possibility of retroperitoneal tumour, especially GN, if a patient suffers from scoliosis with an unknown cause. Thus, CT and MRI are needed to provide additional information that would help formulate a diagnosis.
Collapse
Affiliation(s)
| | - Lu Yang
- Department of Urology/Institute of Urology, West China Hospital/West China Medical School, Sichuan University, Chengdu, China
| | - Ming Shi
- Department of Urology/Institute of Urology, West China Hospital/West China Medical School, Sichuan University, Chengdu, China
| | | | - Ya Liu
- Department of Breast Surgery
| | | |
Collapse
|