Primary holocord ganglioneuroblastoma

Adrenal ganglioneuroblastoma with metastasis near the renal hilum in an adult female: A case report and review of the literature

Ganglioneuroblastoma (GNB), predominantly observed in children, is an uncommon malignant tumor in adults, with established treatment protocols notably lacking. The present study details the case of a 20-year-old woman who presented with a left adrenal gland mass, identified during a physical examination. Additionally, an unidentified mass was noted near the renal hilum in the preoperative evaluation. Following thorough preoperative preparation, both the primary adrenal gland mass and the renal hilar mass were surgically removed. The procedure concluded successfully. Pathological analysis confirmed that the left adrenal mass was a GNB and identified the renal hilar mass as a metastatic extension. Postoperative examination revealed a new formation at the original surgical site, later verified as a postoperative scar. Through the publication of a case report and extensive literature review, the present study aims to enhance our understanding of this condition, providing valuable diagnostic, therapeutic and post-recovery references for this rare adult disease.

Ganglioneuroblastoma of filum terminale

Object

Neuroblastic tumors can be classified as neuroblastoma, ganglioneuroblastoma (GNB), or ganglioneuroma. Ganglioneuroblastomas consist of small, round, immature neuroblast cells and matured ganglion cells. They are most commonly found in the mediastinum and retroperitoneum; intraspinal GNBs are extremely rare. There are only 5 cases of intraspinal GNB reported in the English literature. The authors report a case of GNB of the filum terminale. The duration of follow-up after the initial treatment is longer than in any other published reports.

Methods

A 36-year-old woman underwent resection of an intradural extramedullary tumor at L1–2 in 1993. Pathological diagnosis was GNB. After surgery, her symptoms resolved and she recovered to a normal condition. In 2009, when she was 53 years old, she presented to the hospital with paralysis of both legs. Magnetic resonance imaging suggested recurrence of spinal tumor. She underwent subtotal resection of the tumors, followed by 4 weeks of radiation therapy.

Results

Neurological symptoms improved, and, after radiation therapy, the patient was able to walk with a crutch. Histological investigation of the excised tumor indicated that it was a nodular type GNB, which was consistent with the diagnosis from the time of the initial surgery in 1993. Follow-up MRI studies showed no growth of residual tumors in the 3 years following the surgery.

Conclusions

The authors present a rare case of spinal GNB. The duration of follow-up after the initial surgery in 1993 represents the longest description of clinical course after treatment for spinal GNB.