Abstract
Ganglioneuroma is a rare benign tumour that originates from the ganglion cells of the sympathetic nervous system. They are rare in cervical spine region and only 8 % of ganglioneuromas occur in the neck. The common sites of occurrence are in the posterior mediastinum, retroperitoneum and adrenal medulla, and as such, a cervical occurrence presenting with quadriplegia is a reportable event. We present a 26-year old young male with a two-year history of neck pain and progressive quadriplegia. He later became wheelchair-bound. Musculoskeletal examination revealed multiple generalized nodular skin swellings with café au lait macules. Magnetic resonance imaging showed a huge dumbbell tumour of the first two cervical vertebrae, to the right side of the spinal canal causing significant spinal cord compression. He had surgical intervention, aimed at complete tumour resection, postoperatively, power of the limbs improved to normal. Histological examination was consistent with ganglioneuroma. We present this report because the occurrence of ganglioneuroma is rare, secondly a cervical presentation is unusual and thirdly it presented as a rare cause of quadriplegia.
Highlights
Ganglioneuromas are benign tumours that originate from the ganglion cells of the sympathetic nervous system and adrenal medulla.[1]
The common sites are the posterior mediastinum, retroperitoneum and adrenal medulla, ganglioneuromas are rarely found in the cervical spine region.[4,5,6,7]
Obande JO et al, mass effect causing radiculopathy or myelopathy and weakness of extremities. This is a rare differential in an adult patient with neck pain and limb weakness.11Only 10 cases of cervical ganglioneuromas have been documented in the world literatures as of 2014.12 There has been no documentation of any case of cervical spine ganglioneuroma in the Nigerian literature to the best of our knowledge
Summary
Ganglioneuromas are benign tumours that originate from the ganglion cells of the sympathetic nervous system and adrenal medulla.[1]. Obande JO et al., mass effect causing radiculopathy or myelopathy and weakness of extremities This is a rare differential in an adult patient with neck pain and limb weakness.11Only 10 cases of cervical ganglioneuromas have been documented in the world literatures as of 2014.12 There has been no documentation of any case of cervical spine ganglioneuroma in the Nigerian literature to the best of our knowledge. We report this case of a 26-year old man with cervical spine ganglioneuroma, which is rare, occurring in an unusual site with unusual presentation; and having features of Von Recklinghausen's disease. Musculoskeletal examination revealed multiple nodular skin swellings on the back, neck and upper limbs.
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