Massive thoracic ganglioneuroma with significant mass effect on left hemithorax

Lambdin, Jacob; Lee, Kyongjune B.; Trachiotis, Gregory D.; Picone, Carlose

doi:10.1136/bcr-2017-222250

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…Therefore, the natural cap of tumor mass growth was assumed to be limited by the provided space before any symptom onset was noticed by the patient. The largest GN currently reported was 23 cm in diameter [6]. Thus, our case currently ranks as the largest resected ganglioneuroma.…”

Section: Systematic Literature Reviewmentioning

confidence: 71%

“…As these tumors are generally diagnosed due to compressive symptoms and consequently resected in children, there is usually a natural limit to tumor size given by the available space within the body cavity. The biggest resected GN assessable through literature research up to now showed a maximum diameter of approximately 23 cm [6] in a 42-year-old patient located solely thoracically [6]. Located most commonly in the posterior mediastinum (41.5%) or retroperitoneally (37.5%), ganglioneuromas can be found in the adrenal glands (21%), in the neck (8%), retropharyngeally, or more rarely in the sella turcica [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Total resection of a giant retroperitoneal and mediastinal ganglioneuroma—case report and systematic review of the literature

et al. 2020

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Background Ganglioneuromas (GNs) are extremely rare, slowly growing, benign tumors that can arise from Schwann cells, ganglion cells, and neuronal or fibrous tissues. Due to their origin from the sympathetic neural crest, they show neuroendocrine potential; however, most are reported to be hormonally inactive. Nevertheless, complete surgical removal is recommended for symptom control or for the prevention of potential malignant degeneration. Case Report A 30-year-old female was referred to our oncologic center due to a giant retroperitoneal and mediastinal mass detected in computed tomography (CT) scans. The initial symptoms were transient nausea, diarrhea, and crampy abdominal pain. There was a positive family history including 5 first- and second-degree relatives. Presurgical biopsy revealed a benign ganglioneuroma. Total resection (TR) of a 35 × 25 × 25 cm, 2550-g tumor was obtained successfully via laparotomy combined with thoracotomy and partial incision of the diaphragm. Histopathological analysis confirmed the diagnosis. Surgically challenging aspects were the bilateral tumor invasion from the retroperitoneum into the mediastinum through the aortic hiatus with the need of a bilateral 2-cavity procedure, as well as the tumor-related displacement of the abdominal aorta, the mesenteric vessels, and the inferior vena cava. Due to their anatomic course through the tumor mass, the lumbar aortic vessels needed to be partially resected. Postoperative functioning was excellent without any sign of neurologic deficit. Conclusion Here, we present the largest case of a TR of a GN with retroperitoneal and mediastinal expansion. On review of the literature, this is the largest reported GN resected and was performed safely. Additionally, we present the first systematic literature review for large GN (> 10 cm) as well as for resected tumors growing from the abdominal cavity into the thoracic cavity.

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Section: Systematic Literature Reviewmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Total resection of a giant retroperitoneal and mediastinal ganglioneuroma—case report and systematic review of the literature

et al. 2020

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“…Guan, et al reported a case with a tumor of 21 × 15 × 18 cm in an 8-year-old child [3]. The largest tumor was reported by Lambdin, et al but it was in an adult patient (24 × 10 × 10) [20] (Table 1).…”

Section: Discussionmentioning

confidence: 97%

Giant Thoracic Ganglioneuroma with Mass Effect: A Case Report

Zegmout¹,

Hanane²,

Abdelhalim³

et al. 2020

Int J Pediatr Res

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Thoracic ganglioneuromas are exceedingly rare. They arise from neural crest cells. These tumors are mostly asymptomatic, but massive tumors can present symptoms related to locoregional compression like dyspnea or scoliosis. We report a case of thoracic paravertebral giant ganglioneuroma in a 12-year-old child presenting as a large intrathoracic mass in the posterior mediastinum with intimate contact with the dorsal spine. That masse causes skeletal deformity and scoliosis. Scoliosis secondary to ganglioneuroma is rare and there is no report on its incidence. The diagnosis was made on a CT-guided tarnsparietal biopsy. Our intent is to highlighting the difficulties that may occur during the diagnosis of such patients, especially in view of the unusual clinical signs and the large size of the tumor. As well as the management of paravertebral ganglioneuroma associated with scoliosis, especially in the preoperative phase. CASE REpORTCheck for updates and analysis of the case improved the knowledge of this tumor. ObservationA 12-year-old child without a medical history significant, had been presented witha progressive shortness of breath without other respiratory or extra respiratory associated signs. The child had no loss of weight, and his appetite was good. The clinical examination objectified the presence of a scoliosis attitude and a condensation syndrome of the right hemithorax, there were no abnormalities on nervous system examination.A chest X -ray revealed a large round opacity occu-

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“…This indicates that there may be a The literature review of primary intrathoracic ganglioneuroma. [15] 1992 17/F L N/A Regular No No Osterhouse [16] 2002 25/F L 15 × 7 × 3 Regular No Yes Duffy [17] 2005 27/F R N/A N/A No No Velyvis [10] 2005 15/F R 8 × 8 × 2 Regular No Yes Maruyama [18] 2007 74/F R 6.9 × 5.8 × 1.6 Regular No No Ko [19] 2007 53/F R 9 × 4.5 × 10 Regular No No Zhang [20] 2009 3/F L 5.8 × 4.5 × 4.5 Regular No No Kitagawa [21] 2010 4/F R N/A Regular No No Guan [4] 2012 [22] 2014 [23] 2017 12/F L 12 × 12 × 12 Regular No No Jeon [24] 2017 6/M R 4 × 3.5 × 2 Regular No No Lambdin [25] 2018 42/F L 23 × 10 × 10 Regular No No Algazwi [26] 2020 18/F R N/A Regular No No Elnady [27] 2020 17/F L N/A Regular No No Brock [14] 2020 12/F R 10 × 9.1 × 9.5 Regular Yes Yes Aljuboori [28] 2021 30/NA R N/A Regular No No Tiwari [29] 2022 4/F L 3.8 × 2.5 × 2.3 Regular No No (Continued ) www.md-journal.com potential association between this destructive character of GN and patients' gender. Of course, this also requires larger sample sizes and systematic analysis for verification.…”

Section: Discussionmentioning

confidence: 99%

A giant lobular thoracic ganglioneuroma cause skeletal erosion: A case report and literature review

Zhuang¹,

Ruan²,

Xu³

2023

Medicine

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Rationale: Ganglioneuroma (GN) is a rare tumor that originates from neural crest cells and can manifest in any location along the sympathetic chain. It typically exhibits a circular or oval shape and does not invade the surrounding tissue destructively and the enormous lobular appearance and erosion of adjacent skeletal tissues are extremely infrequent among GN. Patient concerns: A 15-year-old girl presented to our thoracic surgery clinic with a large intrathoracic mass that was incidentally discovered on a chest X-ray. Further imaging with computed tomography and magnetic resonance imaging revealed a lobular profile and an aggressive growth pattern of the tumor, which destroyed the vertebral and rib bones. A tissue sample obtained by needle biopsy was subjected to histopathological analysis, which confirmed the diagnosis of a GN. Diagnosis: Thoracic (posterior mediastinal) GN and Hashimoto’s thyroiditis. Interventions: After thoracoscopic exploration, a thoracotomy was performed to excise the mass. Outcomes: The patient recovered well after surgery, had no major complications, and was discharged without any issues. Further follow-up is necessary to clarify the medium to long-term outcome. Lessons: Based on existing reports, thoracic GN rarely erodes adjacent bone tissue. By examining previously reported cases, we speculate that the lobular morphology of the tumor may be linked to the more aggressive biological behavior of GN. We also discovered that female patients may be more susceptible to bone erosion. However, further research and additional cases are required to confirm these potential associations.

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Massive thoracic ganglioneuroma with significant mass effect on left hemithorax

Cited by 5 publications

References 14 publications

Total resection of a giant retroperitoneal and mediastinal ganglioneuroma—case report and systematic review of the literature

Total resection of a giant retroperitoneal and mediastinal ganglioneuroma—case report and systematic review of the literature

Giant Thoracic Ganglioneuroma with Mass Effect: A Case Report

A giant lobular thoracic ganglioneuroma cause skeletal erosion: A case report and literature review

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