Case study: asymptomatic retroperitoneal ganglioneuroma
This article describes the case of a 29-year-old diagnosed with a retroperitoneal ganglioneuroma that was displacing the patient’s major abdominal organs and vessels. The patient had no significant medical or surgical history except for the fact that she was unable to conceive. Doctors referred her to the General surgery department. Her routine ultrasound examination during the patient’s first pregnancy revealed a small mass in her abdomen.
The patient was initially called back for a follow-up but presented 6 years later for secondary infertility. The mass was now more defined and had increased in size. Examination showed that the patient was asymptomatic and was not on any medications. Her family history was not significant for any malignancy. Abdominal and pelvic CT were significant for a retroperitoneal mass that extended from the pancreas to the pelvis, measuring 6.31822 cm. There were signs of calcification with enhanced soft tissue. The mass was further displacing the inferior vena cava (IVC) anteriorly, whereas the uterus was being replaced laterally. It was causing mild hydronephrosis without invasion. Doctors referred the patient for a CT-guided biopsy to confirm the diagnosis. The findings were consistent with the diagnosis of ganglioneuroma.
Diagnosis and treatment
Ganglioneuromas are benign neuroblastic tumours that are common in children but unusual in adults. Patients with the condition do not usually present with any symptoms and ganglioneuromas are generally diagnosed on routine examinations. However, if the GN is large, it can compress adjacent organs and cause complications. The survival rate, however, is high even in patients with incomplete resection of the tumour. The diagnosis is generally confirmed with a biopsy and standard treatment includes surgery. As with this case, the tumour was an incidental finding. Before treatment, the patient was referred for an MRI to localize the lesion accurately.
The patient was advised of surgical excision of the tumour. She tolerated the surgery and had an uneventful recovery. She was kept under observation in the intensive care unit for one day before being sent back to the ward. The patient was discharged 5 days after the procedure. She remained healthy with no symptoms until 10 months after surgery.
