Multiple cervical ganglioneuroma: A case report and review of the literature

Abstract

Ganglioneuromas (GNs) arising from neural crest sympathogonia are rare benign neurogenic tumors. The most commonly affected sites are the posterior mediastinum, the retroperitoneum and the adrenal gland. GNs often present as a solitary, painless and slow-growing mass, and multiple occurrences in the cervical region are extremely rare. Here, we report a case of massive multiple cervical GN in a 4-year-old girl, and review cases of cervical GN that have been reported in the past 10 years. The results demonstrated that cervical GN, compared to other sites, is seldom secretory. The signs and symptoms of cervical GN are unspecific; the ultimate diagnosis of GN depends on pathological examination. Fine-needle aspiration biopsy has limited value in diagnosis. Surgical excision is the treatment of choice and the prognosis is excellent even in cases where complete excision cannot be achieved. Furthermore, GNs should be considered in patients with multiple masses in the neck.

Keywords: cervical; children; ganglioneuroma; neurogenic tumor.

Figure 1

Contrast-enhanced CT scans. (A) Two masses in the paravertebral and prevertebral region are well-circumscribed with sparse dot-like calcifications. The medially displaced trachea and esophagus, the common carotid artery, internal jugular vein and vagus nerve are displaced anteromedially to the near surface of neck. (B) The bigger mass extends from the skull base to clavicle level, which is anterior to the smaller mass. CT, computed tomography.

Figure 2

Preoperative view of GN with thick neurogenic pedicles in the neck. GN, ganglioneuroma.

Figure 3

Representative histopathological image of GN stained with H&E. GN, ganglioneuroma; H&E, hematoxylin and eosin.