Retroperitoneal Ganglioneuroma in a Patient Presenting With Vague Abdominal Pain.

Malik Hatim Hussain,Muhammad Shoaib Mithani,Zafar Iqbal,Muhammad Noman Khan

doi:10.7759/cureus.9133

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.

Highlights

Ganglioneuromas (GN) originate from the neural crest tissue and are composed of gangliocytes and mature stroma
Ganglioneuroblastoma, neuroblastoma, and ganglioneuroma (GN) are the tumors that arise from the neural crest cells
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

Summary

Introduction

Ganglioneuromas (GN) originate from the neural crest tissue and are composed of gangliocytes and mature stroma. A 40-year-old woman presented to the hospital with vague, gradually increasing abdominal pain for the past two to three months. The repeated CT scan depicted a well-defined mixed density lesion in the retroperitoneum on the right side along with the renal pelvis closely abutting with the duodenum and inferior vena cava anteriorly without invasion measuring 8.5 x 5.3 x 5.0 cm. These findings were suggestive of a benign etiology, and the possible differential included gastrointestinal stromal cell tumor, neurofibroma, or nodal lesion. The patient has been monitored via regular follow-up, and her symptoms have been alleviated

Discussion

Conclusions

Disclosures