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Case Reports
. 2021 Mar 19;21(1):143.
doi: 10.1186/s12893-021-01146-x.

Robotic and standard surgical intervention as adjunct therapies for retroperitoneal ganglioneuroma resection: a case report

Wagner M Tavares  1   2 , Sabrina Araujo de Franca  3 , Amsterdam S Vasconcelos  4 , David S L Parra  1 , Sergio R R Araújo  5 , Manoel J Teixeira  2
Affiliations
Case Reports

Robotic and standard surgical intervention as adjunct therapies for retroperitoneal ganglioneuroma resection: a case report

Wagner M Tavares et al. BMC Surg. .

Abstract

Background: Ganglioneuroma (GN) is ranked by the International Neuroblastoma Pathology Classification as a benign tumor. It can occur anywhere along the sympathetic nerve chain and surgical excision is the treatment of choice.

Case presentation: An 18-year-old female patient sought medical assistance after 6 months of constant dorsal and back pain radiating from the thoracic region to the right abdominal flank. Magnetic resonance imaging revealed a solid nodular lesion with heterogeneous post-contrast enhancement and lobulated contours, centered on the right foramina of D12-L1, with a projection to the intracanal space, which compressed and laterally displaced the dural sac and had a right paravertebral extension between the vertebral bodies of D11 and superior aspect of L2. Ganglioneuroma was diagnosed using immunohistochemical analysis. It was decided to use a surgical approach in two stages: robot assisted for the anterior/retroperitoneal mass and a posterior hemilaminectomy/microsurgical approach to attempt total resection, avoiding the traditional anterior thoracoabdominal surgical incision and optimizing the patient's postoperative outcomes. No postoperative adverse events were noted, and the patient was discharged on postoperative day 5.

Conclusion: This retroperitoneal GN presentation was peculiar because it originated at the D12 nerve root, which extended to the retroperitoneal space and inside the spinal canal. We hope that our case report can assist future decisions in similar circumstances.

Keywords: Adjunct surgery; Case report; Ganglioneuroma; Retroperitoneal; Robotic assisted surgery.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Coronal T2 magnetic resonance imaging. Circle: solid nodular lesion
Fig. 2
Fig. 2
Fibrillar proliferation with a Schwannian pattern next to a nerve segment (arrow). Hematoxylin and eosin staining at 20 × magnification
Fig. 3
Fig. 3
Ganglion cells (arrow). Hematoxylin and eosin staining at 40 × magnification. Superior long axis T2 fast spin echo imaging. Arrow: solid nodular lesion.
Fig. 4
Fig. 4
Superior long axis T2 fast spin echo imaging. Arrow: solid nodular lesion. a Before surgery. b After surgery
See this image and copyright information in PMC

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