A Case of Posterior Mediastinal Ganglioneuroma: The Importance of Preoperative Multiplanar Radiological Imaging

Abstract

Ganglioneuromas are mostly seen in adolescents and young adults and they are neurogenic tumors originating from sympathetic ganglions with a benign histology. Although ganglioneuromas are benign, the treatment is surgical as they can cause pain or compression symptoms, can be locally aggressive and can lead to cord compression. We present a young adult female with a ganglioneuroma of the right posterior mediastinum who presented with lower back pain, together with the clinical features, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) findings, differential diagnosis tips and their contribution to surgical planning. Turkish Başlık: Posterior Mediastinal Ganglionörom Vakası: Preoperatif Multiplanar Radyolojik Görüntülemenin Önemi Anahtar Kelimeler: Ganglionörom, nörojenik tümör, posterior mediasten Ganglionöromlar, daha çok adelosanlar ve genç erişkinlerde görülen, sempatik ganglionlardan orijin alan, benign histolojiye sahip nörojenik tümörlerdir. Benign natürde olmalarına rağmen, lokal agresif davranabildikleri, ağrı ve kompresyona bağlı semptomlar ile kord kompresyonuna yol açabildikleri için tedavisi cerrahidir. Bu yazıda, bel ağrısı şikayeti ile gelen ve sağ posterior mediastinal ganglionörom tanısı alan genç erişkin bayan hasta, klinik özellikleri, BT-MR bulguları, ayırıcı tanı ipuçları ve bunların cerrahi planlamaya katkıları ile birlikte sunulmuştur.

Keywords

• Ganglioneuroma, neurogenic tumor, posterior mediastinum

A Case of Posterior Mediastinal Ganglioneuroma: The Importance of Preoperative Multiplanar Radiological Imaging

Öz

References

1. Lee JY, Lee KS, Han J, Yoon HK, Kim TS, Han BK, et al. Spectrum of neurogenic tumors in the thorax:CT and pathologic findings. J Comput Assist Tomogr 1999;23:399-406. [CrossRef]
2. Geoerger B, Hero B, Harms D, Grebe J, Scheidhauer K, Berthold F. Metabolic activity and clinical features of primary ganglioneuromas. Cancer 2001;91:1905-13. [CrossRef]
3. Strollo DC, Rosado-de-Christenson ML, Jett JR. Primary mediastinal tumors. Part II:Tumors of the middle and posterior mediastinum. Chest 1997;112:1344-57. [CrossRef]
4. Rha SE, Byun JY, Jung SE, Chun HJ, Lee HG, Lee JM. Neurogenic tumors in the abdomen:tumor types and imaging characteristics. Radiographics 2003;23:29-43. [CrossRef]
5. Kumar A, Kumar S, Aggarwal S, Khilnani GC. Thoracoscopy:the preferred approach for the resection of selected posterior mediastinal tumors. J Laparoendosc Adv Surg Tech A 2002;12:345-53. [CrossRef]
6. Shimada H, Ambros IM, Dehner LP, Hata J, Joshi VV, Roald B, et al. The international neuroblastoma pathology classification (the Shimada system). Cancer 1999;86:364-72. [CrossRef]
7. Shields TW, Reynolds M. Neurogenic tumors of the thorax. Surg Clin North Am 1988;68:645-68.
8. Enzinger FM, Weiss SW. Pirimitive neuroectodermal tumors and related lesions. In:Enzinger FM, Weiss SW, editors. Soft tissue tumors, 3rd edn. St. Louis, MO:Mosby, 1995;929-64.

9. Forsythe A, Volpe J, Muller R. Posterior mediastinal ganglioneuroma. Radiographics 2004;24:594-7. [CrossRef]
10. Ko SM, Keum DY, Kang YN. Posterior mediastinal dumbbell ganglioneuroma with fatty replacement. Br J Radiol 2007;80:e238-40. [CrossRef]
11. Kato M, Hara M, Ozawa Y, Shimizu S, Shibamato Y. Computed tomography and magnetic resonance imaging features of posterior mediastinal ganglioneuroma. J Thorac Imaging 2012;27:100-6. [CrossRef] Aughenbaugh GL. Thoracic manifestations of neurocutaneous diseases. Radiol Clin North Am 1984;22:741-56.