Mediastinal ganglioneuroma with osseous invasion simulating malignant transformation of osteochondroma on CT imaging

Abstract

Ganglioneuromas (GN) are rare, mature tumors that arise in the posterior mediastinum or retroperitoneum from neural crest cells and present as slow growing masses in the pediatric population. While they are often found incidentally in unrelated diagnostic workup, they can become symptomatic due to their size and location. They typically demonstrate the nonspecific appearance of a solid mass without invasive or destructive features across different modalities. Such features are normally indicative of more aggressive neoplasms from similar cellular ancestry or an entirely different lineage. Here we present a case of mediastinal GN that on imaging was initially suggestive of an osteochondroma with malignant degeneration based on the presence of an exostosis associated with a large solid mass. Final pathology, however, revealed GN with involvement of the adjacent bone. While the final diagnosis was benign, it is important to recognize this pattern of exostosis with solid mass, especially since the overall survival rate of sarcomata is much worse than that of a classic GN.

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

“…Only a few similar cases have been reported in the previous literature. [12][13][14] In light of these findings, we conducted a review of the literature on intrathoracic GNs from 1990 to the present, to identify commonalities and characteristics of this unusual and destructive growth pattern in intrathoracic GNs. The inclusion criteria are as follows:…”

“…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.…”

Mesenchymal Tumors of the Mediastinum: An Update on Diagnostic Approach

“…It is most often located in the posterior mediastinum. [238][239][240] Ganglioneuroma typically occurs in children and young adults older than 10 years of age. Patients are usually asymptomatic despite the relatively large tumor size.…”

“…Mediastinal ganglioneuroma is the most common of the PNTs. It is most often located in the posterior mediastinum 238–240. Ganglioneuroma typically occurs in children and young adults older than 10 years of age.…”