Retroperitoneal Ganglioneuroma: Mimicking an ovarian mass in a child

Abstract

Ganglioneuroma are rare, benign neural tumor of sympathetic nervous system originating from neural crest sympathogonia. Pelvic ganglioneuromas may mimic ovarian masses. We present a patient operated with the diagnosis of ovarian tumor which had a pelvic gangliuoneuroma.

Case: An eleven-year old female patient complaining of abdominal pain and a mass was seen at our hospital. On examination a 10×10 cm mass was palpable in the pelvis. Laboratory parameters were all normal and the tumor markers such as β-HCG, AFP, CEA, serum catecholamines were negative. Abdominal ultrasonography and computed tomography showed an 11×6×9 cm solid mass containing calcification. The preoperative diagnosis was an adnexal mass of ovary. The patient was operated under general anesthesia and we found a retroperitoneal mass attached to the spine at L5. The tumoral mass was completely excised. Histopathological examination of tumor was reported as ganglioneuroma. The patient was discharged on seventh day of hospitalization with no neurological deficit. Retroperitoneal ganglioneuromas are usually present with local mass a benign tumoral course. The preoperative diagnosis may be difficult in pelvic ganglioneuromas due to close similarity with the ovarian masses. The treatment of the ganglioneuroma is total surgical excision and histology provides a confirmatory diagnosis.

Keywords: Ganglioneuroma; Retroperitoneum; Sympathetic nervous system.

Fig.1

Computed tomography scan shows a mass arising in the retro peritoneum.

Fig.2

Postoperative photograph of ganglioneuroma and capsule.