Gastric Ganglioneuroblastoma in an Elder Man: A Case Report and Literature Review

Abstract

Background: GNB is a moderate tumor of sympathetic origin, which is considered a disease of children with the majority of cases less than five years old and it rarely occurs in adults. There are no treatment guidelines for adults GNB. Here, we reported a rare case of adult gastric GNB, and was resected completely by laparoscopic approach.Case presentation:A 73-year-old man presented with dull pain in the upper abdomen along with abdominal distension for one month. Gastroscopy examination revealed chronic gastritis and submucosal tumor of gastric antrum. Endoscopic ultrasonography showed a hypoechoic mass in gastric antrum arising from the muscularis propria. Combined with the characteristics of gastroscope and ultrasound , the mass was suspected as gastrointestinal stromal tumor. Abdomen CT scan of revealed irregular soft tissue mass in gastric antrum with heterogeneous enhancement in arterial phase, and gastric cancer was suspected.The patient was addressed to the department of gastrointestinal surgery. The mass was completely resected in laparoscopic surgery. Histopathology reported that the mass contained differentiation neuroblasts, mature ganglion cells and ganglioneuromatisis component. Immunohistochemical staining revealed tumor cells were immunoreactive for CD56, Syn, S100 , while negative for CK, CD117, DOG-1, CgA. The pathological diagnosis was GNBi and the patient was staged as stage I. The patient received no adjuvant chemotherapy or radiotherapy.Until his one-year follow-up, the patient was doing well and without any signs of recurrence.Conclusion:Although the rarity of gastric GNB as a primary site of origin, it should be considered in the differential diagnosis of gastric masses in adult. Radical surgery is sufficient for the treatment of GNBi and long-term follow-up should be performed.