Kolonoskopide nadir ve insidental bulgu: soliter polipoid ganglionörom: Olgu sunumu

Year 2019, , 274 - 275, 15.03.2019

Elif Usturalı Keskin , Tufan Yılmaz Gürol Şen

https://doi.org/10.28982/josam.502639

Abstract

Ganglionöromlar (GNs) benign, yavaş büyüyen ve iyi diferansiye nöroektodermal neoplazilerdir. Sempatik sinir sisteminde gelişen nöronal hücrelerden köken alırlar. Çoğunlukla çocuklarda ve posterior mediasten, retroperiton yerleşimlidir. Kolonun insidental soliter polipoid ganglionöromu olgusunu sunduk. 70 yaşında kadın hastaya kanser taraması için kolonoskopi uygulandı. Abdominal ya da intestinal semptomu yoktu. Kolonoskopide kolon hepatik fleksurada 1.4 cm çaplı yuvarlak polipoid lezyon saptandı. Polipten biyopsi alındı. Hematoksilen eozin boyalı histopatolojik kesitlerde ganglion hücreleri ve schwanian stromadan oluşan bifazik polipoid tümör izlendi. Ganglionöromatoz polipozis ve diffüz ganglionöromatozis çeşitli sistemik sendromlarla ilişkilidir. Soliter ganglionöromlar genellikle asemptomatiktir. Ganglionöromlarda tedavi boyut, lokalizasyon, kanama ve obstruksiyon gibi klinik bulgulara bağlıdır. Prognoz genellikle mükemmeldir. Polipoid GN da tedavi polipektomidir. Ganglionöromatoz polipozis ve diffüz formlardaki hastalara kolektomi gerekebilir.

Keywords

Endoskopi, Ganglionörom, Kolon polip, Polipoid ganglionörom

A rare and incidental finding during colonoscopy: solitary polypoid ganglioneuroma: A case report

Abstract

Ganglioneuromas (GNs) are benign, slow growing and well differentiated neuroectodermal neoplasias. They are derived from developing neuronal cells of the sympathetic nervous system. They occur mostly in children and are located in the posterior mediastinum, retroperitoneum. We present a case of incidental solitary polypoid ganglioneuroma of the colon. A 70 year old woman underwent colonoscopy for colon cancer screening. She has no abdominal or intestinal symptoms. In hepatic flexure of the colon a spherical polypoid lesion that was 1.4 cm in diameter was detected endoscopically. Biopsy was taken from the polyp. The histopathology revealed a biphasic polypoid tumour with ganglion cells and schwannian stroma on hematoxylin and eosin stain. Final histopathological diagnosis was polypoid ganglioneuroma of the colon. Ganglioneuromatous polyposis and diffuse ganglioneuromatosis are associated with several systemic syndromes. Solitary GNs are generally asymptomatic. Treatment of GNs depends on their size, location, and clinical findings such as bleeding or obstruction. Prognosis is usually excellent. Polypectomy is curative for polypoid GN. However the patients with ganglioneuromatous polyposis and diffuse form may need colectomy.

Keywords

Endoscopy, Ganglioneuroma, Colon polyp, Polypoid ganglioneuroma

References

• 1. Fiori E, Pozzessere C, Lamazza A, Leone G, Borrini F, Schillaci A, Mingazzini P. Endoscopic treatment of ganglioneuroma of the colon associated with a lipoma: a case report. J Med Case Rep. 2012 Sep 14;6:304. doi: 10.1186/1752-1947-6-304.
• 2. Sayki Arslan M, Ekiz F, Yilmaz G, Coban S, Savas B, Ensari A, Ormeci N. Ganglioneuromatous polyposis of the colon in a patient with multiple adenomatous polyps. Turk J Gastroenterol. 2012;23(6):780-3.
• 3. Ofori E, Ona M, Ramai D, Huang T, Xiao P, Reddy M. Colonic Ganglioneuroma: A Rare Finding during Colorectal Cancer Screening. Case Rep Gastroenterol. 2017 Aug 8;11(2):434-439. doi: 10.1159/000477716. eCollection 2017 May-Aug.
• 4. Kumar S, Singh S, Chandna A. Organ Preservation in a Case of Retroperitoneal Ganglioneuroma: A Case Report and Review of Literature. Case Rep Surg. 2016;2016:6597374. doi: 10.1155/2016/6597374. Epub 2016 Sep 7.
• 5. Matthews MA, Adler BH, Arnold MA, Kumar S, Carvalho R, Besner GE. Diffuse intestinal ganglioneuromatosis in a child. J Pediatr Surg. 2013 May;48(5):1129-33. doi: 10.1016/j.jpedsurg.2013.03.066.
• 6. Abraham G, Prakash SR. Solitary Colonic Ganglioneuroma: A Rare Incidental Finding of Hematochezia. Case Rep Gastrointest Med. 2015;2015:794985. doi: 10.1155/2015/794985. Epub 2015 May 14.
• 7. Shekitka KM, Sobin LH. Ganglioneuromas of the gastrointestinal tract. Relation to Von Recklinghausen disease and other multiple tumor syndromes. Am J Surg Pathol. 1994 Mar;18(3):250-7.