Asymptomatic Giant Thoracic Ganglioneuroma: A Rare Case Report and Literature Review
Keywords:
Ganglioneuroma, thoracic, lobular, skeletal erosion, literature reviewAbstract
Background: Ganglioneuroma (GN) is a rare, benign neuroblastic tumor arising from neural crest cells along the sympathetic chain. It is well-circumscribed, slow-growing, and commonly occurs in the posterior mediastinum (41%), retroperitoneum, adrenal gland, and neck. Despite its benign nature, GN can grow significantly without symptoms and is often detected incidentally.
Case Description: We report a 22-year-old female with an asymptomatic thoracic ganglioneuroma, incidentally identified during a pre-employment medical check-up. Thoracic MRI revealed a well-defined posterior mediastinal mass (11.7 × 10.2 × 14 cm) occupying the left hemithorax. The tumour was successfully resected via a posterolateral thoracotomy, and histopathology confirmed benign mature ganglioneuroma.
Conclusions: Thoracic ganglioneuromas are rare and often asymptomatic, making early detection challenging. Imaging plays a crucial role in diagnosis, and surgical excision remains the preferred treatment for large tumours to prevent complications.
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Husain AN, Koo SC. Diseases of infancy and childhood. In: Kumar V, Abbas AK, Aster JC, eds. Robbins & Catran Pathologic Basis of Disease. 10th ed. Philadelphia, Elsevier; 2020:453-483.
Shimada H, Ambros IM, Dehner LP, Hata J, Joshi V V, Roald B. Terminology and morphologic criteria of neuroblastic tumors: recommendations by the International Neuroblastoma Pathology Committee. Cancer. 1999 Jul 15;86(2):349–63.
Huang Y, Liu L, Li Q, Zhang S. Giant Ganglioneuroma of Thoracic Spine: A Case Report and Review of Literature. J Korean Neurosurg Soc. 2017 May;60(3):371–4.
Decarolis B, Simon T, Krug B, Leuschner I, Vokuhl C, Kaatsch P, et al. Treatment and outcome of Ganglioneuroma and Ganglioneuroblastoma intermixed. BMC Cancer. 2016 Dec 27;16(1):542.
Jiang Z, Zhang T, Liu X, Liang D, Zhong Y, Chan C chao, et al. Multimodal Imaging Features of Bilateral Choroidal Ganglioneuroma. J Ophthalmol. 2020 May 12;2020:1–8.
Lambdin JT, Lee KB, Trachiotis G, Picone C. Massive thoracic ganglioneuroma with significant mass effect on left hemithorax. BMJ Case Rep. 2018 Feb 5;bcr-2017-222250.
Kara T, Oztunali C. Radiologic findings of thoracic scoliosis due to giant ganglioneuroma. Clin Imaging. 2013 Jul;37(4):767–8.
Velyvis JH, Durbhakula S, Wurapa R, Carl AL. Ganglioneuroma with scoliosis of the thoracic spine: a case report. The Spine Journal. 2005 Jul;5(4):457–60.
Guan YB, Zhang WD, Zeng QS, Chen GQ, He JX. CT and MRI findings of thoracic ganglioneuroma. Br J Radiol. 2012 Aug 1;85(1016):e365–72.
Simpson I, Campbell PE. Mediastinal Masses in Childhood: A Review from a Paediatric Pathologist’s Point of View. In 1991. p. 92–126.
Sakai F, Sone S, Kiyono K, Maruyama A, Ueda H, Aoki J, et al. Intrathoracic neurogenic tumors: MR-pathologic correlation. American Journal of Roentgenology. 1992 Aug;159(2):279–83.
Osterhouse MD, Kettner NW, Birrer PT, Mankamyer K. Ganglioneuroma masquerading as spinal pain. J Manipulative Physiol Ther. 2002 Mar;25(3):184–7.
Duffy S, Jhaveri M, Scudierre J, Cochran E, Huckman M. MR imaging of a posterior mediastinal ganglioneuroma: fat as a useful diagnostic sign. AJNR Am J Neuroradiol. 2005;26(10):2658–62.
Velyvis JH, Durbhakula S, Wurapa R, Carl AL. Ganglioneuroma with scoliosis of the thoracic spine: a case report. The Spine Journal. 2005 Jul;5(4):457–60.
Maruyama R, Tanaka J, Maehara S ichiro, Saeki H, Kinjo M, Higashi H. Intrathoracic ganglioneuroma in an elderly patient over 70 years of age. Gen Thorac Cardiovasc Surg. 2007 Oct 12;55(10):437–9.
Ko SM, Keum DY, Kang YN. Posterior mediastinal dumbbell ganglioneuroma with fatty replacement. Br J Radiol. 2007 Oct;80(958):e238–40.
Zhang WQ, Liu JF, Zhao J, Zhao SY, Xue Y. Tumor with watery diarrhoea, hypokalaemia in a 3-year-old girl. Eur J Pediatr. 2009 Jul 20;168(7):859–62.
Kitagawa RS, Satyan KB, Relyea K, Dauser RC, Nuchtern JG, Minifee PK, et al. Video-Assisted Thorascopic Repair of a Subarachnoid-Pleural Fistula in a Child After Thoracic Tumor Resection. Spine (Phila Pa 1976). 2010 Apr;35(9):E347–50.
Kato M, Hara M, Ozawa Y, Shimizu S, Shibamato Y. Computed Tomography and Magnetic Resonance Imaging Features of Posterior Mediastinal Ganglioneuroma. J Thorac Imaging. 2012 Mar;27(2):100–6.
Sánchez-Galán A, Barrena S, Vilanova-Sánchez A, Martín S, Lopez-Fernandez S, García P, et al. Ganglioneuroma: To Operate or Not to Operate. European Journal of Pediatric Surgery. 2013 Dec 10;24(01):025–30.
Huang Y, Liu L, Li Q, Zhang S. Giant Ganglioneuroma of Thoracic Spine : A Case Report and Review of Literature. J Korean Neurosurg Soc. 2017 May 1;60(3):371–4.
Jeon YJ, Son J, Cho JH. Harlequin Syndrome Following Resection of Mediastinal Ganglioneuroma. Korean J Thorac Cardiovasc Surg. 2017 Apr 5;50(2):130–2.
Lambdin JT, Lee KB, Trachiotis G, Picone C. Massive thoracic ganglioneuroma with significant mass effect on left hemithorax. BMJ Case Rep. 2018 Feb 5;bcr-2017-222250.
Algazwi DAR, Elizabeth GL, Bhandari YR, Hallinan JTPD. Pathological Thoracic Spine Scoliosis Due to Ganglioneuroma. Am J Phys Med Rehabil. 2020 Jan;99(1):e13–4.
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 May 7;6:12.
Brock CL, Sharma A, Villada FA, Schubert J. Mediastinal ganglioneuroma with osseous invasion simulating malignant transformation of osteochondroma on CT imaging. Radiol Case Rep. 2021 Jan;16(1):18–21.
Aljuboori Z. Thoracic ganglioneuroma with extension into the epidural space. Br J Neurosurg. 2024 Jul 3;38(4):948–9.
Tiwari S, Arimbrakkunnan M, Yadav T, Vyas V, Rathod KK, Vishwajeet V. Thoracic Ganglioneuroma Presenting with Paraneoplastic Cerebellitis and ROHHAD-NET Syndrome. Ann Indian Acad Neurol. 2022 Mar;25(2):307–9.
Nemoto Y, Kuroda K, Mori M, Kanayama M, Kuwata T, Takenaka M, et al. Robot-assisted thoracoscopic resection of a posterior mediastinal tumor with preserving the artery of Adamkiewicz. Surg Case Rep. 2022 Dec 6;8(1):129.
Chen SL, Liu G, Cui MQ, Yan XB. Using imaging to diagnose lipomatous ganglioneuroma: a case report and literature review. Ann Transl Med. 2022 Jan;10(1):27–27.
Zhuang H, Ruan Z, Xu C. A giant lobular thoracic ganglioneuroma cause skeletal erosion: A case report and literature review. Medicine. 2023 Jun 9;102(23):e33891.
Chauhan D, Bonasso P, Udassi JP, Mascio CE. En Bloc Resection of a Giant Ganglioneuroma of the Chest Through Clamshell Thoracotomy. World J Pediatr Congenit Heart Surg. 2024 Jan 4;15(1):116–8.
Song L, Zhang J, Tian B, Li Y, Gu X, Zhang Y, et al. Giant ganglioneuroma of the mediastinum: a case report. Front Oncol. 2024 Oct 16;14.
Dinh HTP, Yamato Y, Hasegawa T, Yoshida G, Banno T, Arima H, et al. Adolescent thoracic scoliosis due to giant ganglioneuroma: a two-case report and literature review. Nagoya J Med Sci. 2024 Nov;86(4):711–9.
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