Giant Ganglioneuroma of Thoracic Spine: A Case Report and Review of Literature

Abstract

Ganglioneuroma (GN) is a rare benign tumor of neural crest origin usually found in the abdomen, but may occasionally present at uncommon sites including the cervical, lumbar, or sacral spine. However, GNs of thoracic spine are extremely rare. In this report, we describe a 12-year-old girl with giant GN in the thoracic spine, who underwent successful resection (T1-4 level) of the tumor. Histopathological examination confirmed the diagnosis. GN should be considered in the differential diagnosis of any paraspinal mass. A high index of suspicion and correlation of clinico-radiological findings is necessary in differentiating a large benign tumor from a malignant growth. Complete surgical excision is the treatment of choice; however tumor size and location need to be considered for the surgical approach (one-step or multiple surgeries). Close follow-up after surgery is mandatory.

Keywords: Ganglioneuroma; Intradural tumor; Surgery; Thoracic spine.

Fig. 1

Preoperative MRI. A: Coronal T1-weighted image showing a giant, mildly hypointense left-sided mass. B: Sagittal T1-weighted MRI showing a hypointense strip at the T1–T4 level. C: Axial T2-weighted MRI at the T3–4 level showing a heterogeneously hyper-intense mass extending to the spinal canal. MRI: magnetic resonance imaging.

Fig. 2

H&E stained section showing mature ganglion cells surrounded by schwann cells and fibrillary stroma (400×).