Using imaging to diagnose lipomatous ganglioneuroma: a case report and literature review

Abstract

We report a case of a well-defined lesion in an asymptomatic patient with lipomatous ganglioneuroma (LG) located close to the left thoracic spine. Its intensity was heterogeneous with adipocytes. The lesion extended into the spinal canal through the enlarged left intervertebral without bony erosion. The imaging, clinical, and pathological features of the tumor are analyzed. Contrast-enhanced magnetic resonance imaging (MRI) revealed that the lesion was moderate enhanced. 18-F-fluoro-2-deoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) demonstrated high 18-F-fluoro-2-deoxyglucose (18FDG) uptake of the tumor lesion. The finial preoperative diagnosis from our radiologists was that the tumor may be a liposarcoma or neurogenic tumor, but pathology showed that this was incorrect. Some related literatures were reviewed for reference to summarize imaging characteristics of this disease and to assist radiologists in making more accurate diagnoses. All of the lesions had adipocytes in reviewed literature, and the fat-suppressed images showed that there was some low signal intensity within the lesions, some lesions had widened neural foramina and extended into the spinal canal, and some lesion had calcifications. LG is an extremely rare variant of ganglioneuroma. Using the correct measurement of the CT value, applying MRI for fat-suppressed images, using in phase, out phase and contrast-enhanced sequences, using FDG-PET/CT, mastering LG imaging diagnostics characteristics, and combining all of this with clinical, morphological characteristics and pathology results can help clinical workers decrease the misdiagnosis rate of LG.