A Case of Cutaneous Ganglioneuroma Developing within a Lesion of Seborrheic Keratosis

Abstract

A 67-year-old man noticed on the abdominal skin a coin-sized verrucous plaque, in which a small granulation-like lesion developed several weeks before the first consultation at our clinic. The histology of the biopsied granulation-like lesion showed a well demarcated, but not associated with the collagenous capsule, mass of proliferating eosinophilic cells, consisting of intervening spindle-shaped Schwann cells and mature ganglion cells scattered in the tumor nest. We diagnosed this tumor nest as a ganglioneuroma, which rarely develops in the skin tissue. The simply resected surrounding verrucous lesion was histologically seborrheic keratosis.

Cutaneous Ganglioneuroma Associated With Overlying Hyperkeratotic Epidermal Changes: A Report of 2 Cases

“…Prior reports of cutaneous ganglioneuroma describe a certain degree of epidermal hyperplasia overlying the lesions; however, only 2 cases were characterized as associated with seborrheic keratoses. 3,4,6,7,[9][10][11] Though the presence of 2 lesions is a possibility, given multiple cases with varying degrees of epidermal hyperplasia (from mild hyperplasia to verrucous keratosis in our cases), such epidermal changes are likely a manifestation of ganglioneuroma. 10 Induction of epidermal hyperplasia is certainly seen in other mesenchymal tumors such as granular cell tumors and dermatofibromas.…”

“…The first case report of primary cutaneous ganglioneuroma occurred in an extensive report in 1934, and since that time, there have been 12 additional cases in the English literature. [1][2][3][4][5][6][7][8][9][10][11] Primary cutaneous ganglioneuroma is a unique histologic entity and brings into consideration a limited differential. We report 2 cases of cutaneous ganglioneuroma associated with varying degrees of overlying hyperkeratotic changes.…”

Cutaneous ganglioneuroma within a giant congenital nevus

“…It may be multiple and extensive, arising from neuroblastoma metastasis (18,21), neurofibromatosis and endocrine adenomatosis (8,(22)(23)(24). Ganglioneuromas have also been known to expand within cutaneous lesions (1). The pathogenesis of cutaneous ganglioneuromas is still controversial, but it has been postulated that cutaneous ganglioneuroma is a combined heterotopia of ganglion cells and hamartomatous neuroma (4) or simply a choristoma in cases where the ganglion cells are present without the neurofibromatous component (5,6).…”

“…Most often they represent intra-abdominal solid tumours, but in 2% to 5% of cases neuroblastic tumours can be observed in tumours of the cervical region. Neuroblastoma is often referred to as an intra-abdominal mass in infancy (1), and corresponds to the least differentiated form, with a high propensity for metastasis. On occasion, neuroblastoma arising within the abdomen may even metastasize to the neck.…”

“…N erve cell tumours are very rare. Ganglioneuromas are primarily benign lesions developing in the sympathetic nervous system and most often arise in the posterior mediastinum, retroperitoneum and medullary portion of the adrenal gland (1). A small number of cases have been reported in the skin (1-10) and, most often, these lesions develop after birth.…”