Localized Multifocal Retroperitoneal Ganglioneuroma with an Infiltrative Appearance on Imaging: A Case Report
Creators
-
1.
University of Southern California
Abstract
Multifocal ganglioneuromas are characterized by the presence of multiple benign neuroepithelial tumor nodules and are less common than solitary tumors. A small percentage of ganglioneuromas present with a fatty appearance. Only a few cases of multifocal ganglioneuromas have been reported, due to both their rarity and minimal symptomatic presentation; therefore, generalizations about risk factors and predictive markers are very difficult. Here, we report a case of multifocal retroperitoneal ganglioneuroma with an infiltrative appearance on computed tomography (CT). The tumor demonstrated slow growth on multiple imaging studies and was associated with abdominal and flank pain. The aggressive appearance eventually led to surgical resection 18 months after the initial incidental finding on CT. Postsurgical analysis of the tumor on imaging was crucial in revealing its nodularity and infiltration, as well as for clarifying its retroperitoneal location inseparable from the adrenal gland. Histology demonstrated Schwann cells and ganglion cells without atypia or increased cellularity, and with no mitosis or necrosis seen. Our case highlights the consideration of ganglioneuroma with fatty infiltration in the differential diagnosis of a fatty tumor in the mediastinum or retroperitoneum. Additionally, our report differentiates multifocal ganglioneuroma with fatty infiltration from lipomatous ganglioneuroma on radiology and histopathology.
Copyright and License
© 2023 The Author(s). Published by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
Acknowledgement
The authors would like to thank the patient for generously allowing us to document this case.
Contributions
The manuscript was written by Joseph Rich. The manuscript was overseen and edited by Vinay Duddalwar, Phillip Cheng, Ramon Ter-Oganesyan, Shefali Chopra, and Peter Hu. Radiologic images were acquired and annotated by Vinay Duddalwar and Phillip Cheng. Pathology findings from the resection specimen were documented by Shefali Chopra. Pathologic images were acquired and annotated by Shefali Chopra and Manju Aron.
Funding
No funding was received.
Conflict of Interest
The authors have no conflicts of interest to declare.
Ethics
Written informed consent was obtained from the patient for this publication and all accompanying images. There is no identifying information revealed in this publication. This retrospective review of patient data did not require ethical approval in accordance with local or national guidelines.
Files
cro-2023-0016-0001-534060.pdf
Files
(7.4 MB)
| Name | Size | Download all |
|---|---|---|
|
md5:6dd4def23f6623f20467b996deb7ead4
|
827.5 kB | Preview Download |
|
md5:25c49f3f09e89e9c32beb741e2331f69
|
6.5 MB | Preview Download |
Additional details
Identifiers
- PMCID
- PMC10601809