Posterior mediastinal dumbbell ganglioneuroma with fatty replacement

Abstract

We report a case of a posterior mediastinal dumbbell ganglioneuroma with fatty replacement on CT and MRI. Most dumbbell tumours are neurogenic in origin. Fatty replacement of non-lipomatous malignancies is rare. This report suggests that a ganglioneuroma with fatty replacement should be added to the differential diagnosis of fat-containing posterior mediastinal tumours.

CT and MRI findings of thoracic ganglioneuroma

“…Some researchers regard adipose tissue in the posterior mediastinal lesion as a characteristic feature for diagnosis of ganglioneuroma [9,11,13]. Only two cases in our study showed adipose tissue, and they were misdiagnosed pre-operatively due to lack of knowledge.…”

“…Thoracic ganglioneuroma needs to be differentiated from other tumours [8,13,15,16]. Cystic teratoma is round with multiple cavities, as well as calcification in the cystic wall.…”

“…It often occurs in the retroperitoneal space and posterior mediastinum [1][2][3]. Though abdominal ganglioneuroma is often summarised in the literature [3][4][5][6][7], thoracic ganglioneuroma is sporadic and rarely reported [8][9][10][11][12][13]. Because there is a lack of knowledge about thoracic ganglioneuroma, preoperative misdiagnosis often occurs in clinical practice.…”

Morphological differences between schwannomas and ganglioneuromas in the mediastinum: utility of the craniocaudal length to major axis ratio

“…[2][3][4][5][6][7][8][9] Ganglioneuromas are derived from the primordial neural crest cells that form the sympathetic nervous system and are composed of a combination of mature ganglion cells and other mature tissues. Ganglioneuromas are most commonly located in the posterior mediastinum, followed by the retroperitoneum and adrenal gland.…”

“…Regarding the characteristics of their internal structures, calcifications are often seen and they predominantly exhibit low to intermediate signal intensity on CT. [3][4][5] Previous studies have reported that some ganglioneuromas display a whorled appearance caused by curvilinear internal structures or fatty components, which are detected in approximately half and one-third of cases, respectively. 4,6,7 Schwannomas are encapsulated spherical masses that are mainly found in the posterior mediastinum. However, they sometimes grow through the intervertebral foramina and form dumbbell-shaped lesions.…”